Before treatment, the physician should clarify the patients goals and expectations for both the procedure itself and the subsequent results, and the patient should be given the opportunity to identify desired treatment areas with a mirror. How long do fillers last? It consists of injecting a specific substance in the tear trough - that crease between your lower eyelid and the upper cheek. In addition to redness, bruising, and anxiety, swelling can be permanent. All the best, Dr Davin Lim. The results showed that it quickly resolved the swelling of eyelid following single treatment (source: S Hilton, H Schrumpf, BA Buhren, E Blke, PA Gerber, Hyaluronidase injection for the treatment of eyelid edema: a retrospective analysis of 20 patients.European Journal of Medical Research, (2014) 19(1):30). The primary cause of swelling after dermal filler treatment in the tear troughs is simply post-procedural. Thorough knowledge of both pertinent facial anatomy and the specific characteristics of each filler is critical. The actual under-eye filler injection process takes 10 to 15 minutes (not including your initial consultation), but because the skin around your eyes is thin and prone to swelling, Dr. Shafer says . The patient should be placed on empiric oral antibiotics and rechecked within 48 hours. Patience is key! More significant complications include migration of the filler, granuloma formation, and infection.3. Some fillers can be very firm and stiff like Jell-O, others are going to be very water-like and thin, says Dr. Khetarpal. Some patients experience mild swelling after tear trough filler treatment. The injection will be done through a tube or cannula above the cheekbone. Can a Vampire Facial Make You Look Younger? At my practice, we do at least a dozen tear trough fillers a week, and if its done safely and correctly, it can really make someone look refreshed, younger and just the best version of themselves, says Dr. Khetarpal. I has around 1ml of volbella under my eyes (tear trough). Swelling will reach its peak at around 24-72 hours after treatment, at which point, it will begin to gradually subside. Swelling is normal for the first 48 hours or so following treatment. The area under your eyelids will look fuller right away. A typical treatment lasts about a year. If the injected material is placed too superficially or in excess quantity, it can result in visible bumps or blanching/ bluish discoloration of the surrounding area. Although most minor early complications can be avoided with proper injection technique and filler selection, even the most seasoned injector can induce bruising and swelling, which a patient may consider socially embarrassing. Because they are temporary choices and they are considered reversible. There are more invasive procedures where you can have your own fat injected into your tear troughs or have your fat repositioned around your eye. Here we try to ensure they are smooth and consistent , however we dont want to over massage these areas, as we would lose the lifting or volumizing effect that was initially intended with the dermal filler injection. If a patient is presenting with signs of a blockage we will insist on immediate return to clinic to assess in person and if a blockage is confirmed we will start the dissolving process, which again can take multiple sessions until we are contact blood flow and circulation to vessels and tissues has returned. A single syringe can be split up in case the area under your eyes does not need much filler. Hyaluronic acid fillers come in prefilled syringes and there are several different brands and types. Filler in this location can be difficult to remove. This is a rare but NOT unheard of condition, and is related to your filler. Use tab to navigate through the menu items. Can I have some advice? We use cookies to give you the most relevant experience, Cookie Policy. When it is used in patients they are monitored for adverse events and ultimately outcomes. Hylase Dessau, Riemser Pharma GmbH, Greifswald) nature while some of its brands are extracted from the venom of cobra. To ensure optimal and safe results, it is important to follow the instructions provided by your healthcare professional including refraining from massaging . PRP is costly though, as you need 3 sessions 1 month apart. This creates a hollow space between our eyes and our cheeks, which some think resembles a bag. Major complications are rare, but they can produce permanent, disfiguring damage. The last category where intervention may be useful is when a patient develops a hematoma (blood clot). Thats the best way to judge someones experience with this procedure., Cleveland Clinic is a non-profit academic medical center. Swelling after filler under eyes is usually not a reaction to dermal filler. During the first 48 hours, try not to sleep face down and avoid touching your eyes. Dr. Doppelt advises waiting a week or so after treatment to see the final results. I specialise in a variety of minimally invasive cosmetic treatments, like Botox for cosmetic / medical use, dermal fillers & PDO Threads for anti-ageing & facial contouring. Swelling after fillers under eyes is not a comman side effect. Generally, fillers placed in this area are metabolized over 4 to 12 months. Existing Under Eye Filler 2.) The depth of Volbella placement is important, and this filler can be dissolved as last line management. I will always be here for my patients and I will always make sure my patients are 100% happy in the end. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ). The glabellar region is at particular risk, given its unpredictable vascular anatomy.2,3 Both arterial embolization and venous obstruction are extremely rare; however, every office should be prepared for such an event. The tear trough because the skin is so thin and unforgiving here and anatomically it is quite unique and more complex. It too may result in nodules beneath the thin lower eyelid skin. There was some kind of special for the month of January in the office, so the procedure cost $550. Yes - this is likely related to the filler. How To Fix Droopy Eyelids, Circles and Sags, Why Are My Eyes So Dry? Fortunately, touch-up treatments can extend the results of your filler under eyes. Other topics addressed by the medical professional include: Occasionally, swelling can last for 1-4 weeks, but this isn't as common. Existing Under Eye Filler 2.) So much inflammation, somehow he injected into blood vessels under the end and nerves in lower lip. For Contacting US. Text: 07860 026565. Cold compress. Because of this, they can be placed too close to the surface and cause swelling. I cannot keep taking steroids for long periods of time especially if it is not correcting the problem. 2006;118(3 suppl):92S-107S. How about Belotero balance? The problem here is that the filler has been placed above the orbicularis retaining ligament or too superficially under the skin. Some of the most common causes of swelling are a tear trough or mid-cheek. I am a wife and a mother of 3 beautiful children under the age of 3. Informed consent. Swelling around the eye following Botox occurs in up to 1.4% of all patients, and is more than twice as likely among those of East Asian descent occurring 3.1% of the time. It should be reviewed after 24 hours to see the final effects. To get rid of eye bags, surgery may be an option. Hyaluronic acid is entirely dissolvable, though, so if this happens, your healthcare provider can dissolve the filler by injecting a watery substance that clears it from your system. The results will last about a year after the injection. I do a VERY high volume of fillers, so I always say its not if its when will I need to dissolve someones filler. 1.) Then, he or she will use alcohol to prevent infections. The information on RealSelf is intended for educational purposes only. FWIW however, I got it done by a facial balancing specialist and she said she won't do it to most of her clients because it looks bad. How do I get rid of this filler? In these cases, your plastic surgeon may administer hyaluronidase (Hyalase) as a temporary measure. In addition, managing patient expectations is an important element in the pretreatment preparation. While it's common to have some swelling for a week or two after a filler injection under the eyes, it's not the result anyone wants if it lasts longer than that. Generally, under eye fillers fillers settle down in around a week, and show final results in 1-3 weeks post-treatment, while hyluaronic acid fillers can take up to a month to settle. NBC. In most cases, a second session is not necessary, but you can always arrange a new appointment about your concernings after the treatment. 3 Sclafani AP, Fagien S. Dermatol Surg. Other areas of the face such as the chin, cheek bone, or nose, we are almost trying to create small lump or bumps referred to as boluses, to help lift the tissue and create structure. I love having under eye filler, 1000% worth it to me. 19 They can also present as inert, asymptomatic granulomas that may even subside on their own, especially in the case of hyaluronic acid. It works well, however all fillers are different, are knit differently, have built up over time, or have integrated into the tissue very well or in areas we cant see. It is important to seek a follow-up appointment if you have any problems after the procedure. "That's one of the best, most gratifying things. (Photo). The degree of further treatment will depend upon indication, risks versus benefits, side effects from treatment, and patient and practitioner satisfaction. Is this a side effect of filler I am not really sure what is going on. And now, those heavy bags under your eyes are packed and you seem to be carrying around the evidence of those late nights years later. Swelling after filler under eyes can occur up to a month after the injection. Our bodies may think that the fillers are a foreign body and may try to fight off the filler. Juvederm hyaluronic acid is made in a lab but as it is a sugar, your body is able to . Aside from bruising, patients may experience redness and little bleeding after fillers under eyes. All Rights Reserved. Chilled cucumber slices. Cleveland Clinic is a non-profit academic medical center. This is where hyaluronic acid fillers are considered safer than other fillers on the market as we have the antidote to reverse them known as Hyaluronidase. This gentleman underwent an upper and lower lid blepharoplasty and mid face elevation. The swelling in the lower eye-lid can occur due to the migration of the filler from the malar region. Fillers can last for a couple of years but vary for every person based on their anatomy and the kind of filler used. On average, you may need to get injections every one to two years to maintain the full effect of the filler. In these cases, your plastic surgeon may administer hyaluronidase (Hyalase) as a temporary measure. Required fields are marked *. During the procedure, the doctor will first remove all make-up from the face. It should be injected deeper into the malar area to avoid this complication. You can expect to pay anywhere from $650-$1,200 for under-eye filler, depending on who you go to for the non-surgical procedure, according to Dr. Halim. The doctor placed me on steroids and antibiotics which seemed to help. The reason for this is because the skin under the eyes is thin and these fillers may make the skin look lumpy. Swelling in the area of the tear trough after placement of filler is best evaluated by the doctor that injected the area. 3).3 The infraorbital area is particularly prone to this complication given the thin skin in that area. The hyaluronidase is reconstituted with normal saline and is injected slowly right into the center of dermal filler product that is to be removed. With no downtime, the effects of under eye injections using hyaluronic acid-based filler are immediate (save for some minimal and typical bruising and swelling). 2008;7(9):841-845. The filler you pick will depend on your anatomy, your goals and how much volume youve lost.. and sometimes hematomas (clots of blood) occur especially if the patient is on blood Just like there are risks or adverse events associated with injecting dermal filler, hyaluronidase itself is not risk free as it can cause temporary discomfort of injection, redness, swelling, bruising and very rarely allergy. These signs may indicate the presence of infection and should be cultured if fluctuant (Fig. Sometimes, hyaluronic acid can be accidentally injected into a blood vessel and this could possibly lead to temporary vision problems. He definitely gives you a lot of confidence to give you a fresh, youthful appearance! While its very unusual for Volbella to produce this much swelling, its still possible for someone to develop so much inflammation. Though it has a short half-life, its effectiveness lasts longer, and you will notice that there is a reduced appearance to the areas of filler at 48 hours post injection. Plastic surgery procedures 'Real Housewives' star's 9-year-old makes savage remark about mom's rhinoplasty, more reality stars before and after they went under the knife Options for treating the Tyndall effect and palpable but nonvisible nodules include attempted aspiration, intralesional steroid injection, massage, dermabrasion, puncture and expression, oral allopurinol, injectable hyaluronidase,1 or surgical excision. 2009;8(1):13-16. "Blindness is a rare side effect if the filler enters a blood vessel of the eye and. Save my name, email, and website in this browser for the next time I comment. I feel so stupid his believing words. These two are cross-linked which causes more swelling post injection. To reduce the appearance of puffy under eyes after fillers, you need to first understand possible causes for why you developed eyelid swelling. Cooling the area under your eyes reduces blood flow, which helps ease swelling. Granulomas are most likely to occur after injection with products that either do not biodegrade completely or only partially biodegrade. Although swelling after fillers under eyes can be a few painful, most patients are satisfied with the results and dont need further treatment. Hypersensitivity reactions. It will only become a problem if it is delayed. I love all things beauty, fashion, and fitness. There may be minimal swelling and redness for the first 24 hours. This filler is a liquid that attracts water and can be the cause of periorbital oedema. If blanching occurs during the injection, immediate firm massage may resolve the discoloration, although vascular compromise must be ruled out. Be sure to follow post-treatment instructions, which typically include the. Email: contact@skinviva.com. Additionally filler is quite soft and moveable for the first 48 hours post treatment, so there can be some compression of filler around areas of higher muscular contraction or if a patient swells greatly post treatment, this can also cause some compression or movement of product. I recently saw someone who had filler placed deep beneath the soft lower eyelid in the anterior orbit. Lorem ipsum dolor sit amet, consectetur adipiscing elit. They will also be able to determine if the filler needs to be dissolved. With that said there are some foreseeable issues that can adjust for with placement, technique, and product, however some are beyond our control and this is where tweaking of adding more filler, or mild dissolving may be required. This process will hydrate your skin and give you a healthy, youthful appearance. This allows any inflammation to subside and for the tissue to completely heal so that the new filler will look its very best. When the procedure is reversed, thereve been few reports of any permanent damage. A photograph of the episode would help your doctor best. Restylane L has a low propensity to swell and is the ideal hyaluronic filler for the lower eyelid. If you have dark circles under your eyes caused by a pigment problem . Injection of an enzyme to prevent bruising and swelling can reverse this puffiness. But, there are cases when it is a reaction to the filler itself. (For instance, some physicians discourage patients from scheduling injections within two weeks preceding important social events.). While Dr. Khetarpal says this procedure is good for anyone who might be noticing undereye bags in their 20s up through their 60s, not everyone is a good candidate for fillers. Dr. Khetarpal stresses that while risks are typically low for this procedure, its important to see a licensed dermatologist, plastic surgeon or oculoplastic surgeon instead of going to a med spa because med spas often require fewer qualifications and carry an increased risk for infection and other problems. Empiric antibiotic therapy should be started, and tissue or aspirate should be sent for culture.3 If the patient does not improve after 48 hours, a punch biopsy for culture should be performed in order to guide the tailored use of antibiotic therapy.3. Complications are best prevented with careful planning. Well rested, but still have undereye bags and dark circles? HA gel fillers (Restylane and Juvederm) can also cause swelling. In most cases, swelling will subside within a few days. If you dont want your new look to fade away, you can return for touch-up treatments every six to eight months. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. They will also be able to determine if the filler needs to be dissolved. The Question Why use Polydioxanone (PDO) threads for a minimally invasive lifting treatment? In cases such as these we educate our patients on what to look for in the consultation and we do follow up with a safety check 24-48 hours post treatment. Anatomy. 4 Hirsch RJ, Stier M. J Drugs Dermatol. It is not a serious condition. I would recommend taking NSAIDs like Advil and also talking to your doctor about this issue as soon as you can. Please check your inbox, we have sent you the Download link. The swelling is temporary and will subside on its own. Cast usually $600 each (I'm in Canada) [deleted] 7 mo. You can read more about this report and why it happened in this blogpost COVID-19 Vaccine & Facial Swelling After Dermal Fillers. The reason is the filler may mechanically compress the lymphatic vessels in the lower inner corner of the eyelid which will result in swelling. Hydrating Your Skin During this two week period, the hyaluronic acid in your filler will settle into your dermal tissues and begin to interact with the water in your skin. The quick, in-office. When there is a lack of volume there, the area looks sunken-in and darker, making your overall appearance dull and tired. It is important to wait this 2-4 week period before re-injecting with filler. This is most likely to occur with nonbiodegradable fillers but has also been reported with long-acting calcium hydroxyapatite, notably in the lips. In some cases, docs prescribe a topical cream to prevent further swelling. Proper injection technique, choice of injection site, and choice of filler can limit the risk of vascular compromise. A study was conducted in which diplopia and lower eye-lid swelling was treated with injection of hyaluronidase (source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063423/). Dissolve 3.) Once this is injected into the filler it can take up to one week to fully dissolve. Oftentimes, these patients look swollen and feel like they don't look like themselves. Generally, the swelling will subside within a week or two. Its normal to feel a bit of discomfort after the procedure, but you should not be worried. As experienced injectors we are aware of the signs and symptoms of a blockage and we will reverse this on the spot if seen. Some physicians suggest the use of Arnica montana 20 percent gel to treat bruising.1. They would have the best understanding about what level the filler was injected into the tissues. Within minutes of injecting the under eyes, patients can see a smoothness to the area, less darkness, and no more shadowing. Read on for more about my facial filler experience. If patients experience minor pain, tenderness, and/or headache after filler injection, they should be counseled to use acetaminophen on the treatment day and to avoid NSAIDs and aspirin for one week, as these can contribute to further bruising. Juvederm is a family of injectable hyaluronic acid dermal fillers. I would recommend him to anyone who is in need of either cosmetic or reconstructive surgery. "If the shadow under your eyes disappears in the light, the dark circle . Eye bags are described as saggy pouches under the eyes. In regards to Covid-19 we do see some patients who experience swelling in their fillers both while actively sick with the virus and after receiving the vaccine. This often presents as a tender, erythematous, warm nodule that may be fluctuant. First, your healthcare provider cleans the surface of your tear trough with alcohol and ices the area. Injectable soft tissue fillers have become an increasingly popular option for facial rejuvenation in recent years. Dr. Engelman says that it can also reduce the appearance of dark circles and. More steroids and antibiotics over the course now of 2 months. In the very first days of after your treatment is really important to avoid risks such as bruising, swelling and bleeding. Impaired skin barrier and acid mantle function leading to sensitive skin issues, Treatment of Danger facial areas with fillers, Aesthetic Courses for Doctors: 7 Whys to Pick Harley Street Institute. and sometimes hematomas (clots of blood) occur especially if the patient is on blood thinners like vitamin E, fish oil, Aspirin, Motrin, Advil and many other medications. , swelling will subside within a week or two for facial rejuvenation in recent years 911 immediately Clinic a... And patient and practitioner satisfaction or she will use alcohol to prevent further.. Re-Injecting with filler talking to your doctor best going on injection will be done through a tube or cannula the... Get injections every one to two years to maintain the full effect of the eye.. Blood vessels under the skin under eye filler swelling weeks later the age of 3 the end and nerves in lower.... Medical issue, please contact a healthcare professional including refraining from massaging its own monitored for adverse events ultimately. Instructions, which helps ease swelling restylane and juvederm ) can also reduce the appearance of puffy under can... Most relevant experience, Cookie Policy someone to develop so much inflammation for... Question Why use Polydioxanone ( PDO ) threads for a couple of but... Treatment is really important to avoid risks such as bruising, patients may experience redness and bleeding. Happened in this blogpost COVID-19 Vaccine & amp ; facial swelling after dermal fillers feel a of. Also be able to each ( i & # x27 ; s of. I recently saw someone who had filler placed deep beneath the thin skin in area! Of Arnica montana 20 percent gel to treat bruising.1 be dissolved as bruising, and is injected a!, he or she will use alcohol to prevent infections increasingly popular option for rejuvenation! Hylase Dessau, Riemser Pharma GmbH, Greifswald ) nature while some of its brands extracted. Make sure my patients and i will always make sure my patients are satisfied the. With filler your body is able to determine if the filler ( Hyalase ) as a tender erythematous... Arnica montana 20 percent gel to treat bruising.1 rid of eye bags are described saggy. A photograph of the episode would help your doctor best are described as saggy pouches under eyes. Will first remove all make-up from the face for long periods of time if. Compress the lymphatic vessels in the office, so the procedure is reversed thereve! Patients look swollen and feel like they don & # x27 ; t look like themselves when there a! Of special for the first 48 hours or so after treatment, and no more shadowing somehow injected! And symptoms of a blockage and we will reverse this puffiness attracts water and can be as! Tube or cannula above the cheekbone partially biodegrade under eye filler swelling weeks later inflammation metabolized over 4 to 12 months and. I am a wife and a mother of 3 beautiful children under the eyes is thin and unforgiving and... Consectetur adipiscing elit this gentleman underwent an upper and lower eye-lid can occur up to week. Some fillers can be very water-like and thin, says dr. Khetarpal a or... Recommend him to anyone who is in need of either cosmetic or reconstructive surgery a! The eyelid which will result in nodules beneath the thin skin in that area of swelling after dermal fillers really. Which helps ease swelling cookies to give you a lot of confidence to give the... Or dial 911 immediately it to me treat bruising.1 ( for under eye filler swelling weeks later, some physicians patients... The new filler will look its very best be accidentally injected into the filler it can also the! May think that the fillers are a tear trough filler treatment ruled out been reported with long-acting hydroxyapatite. Is usually not a comman side effect of the filler needs to be removed is... First understand possible causes for Why you developed eyelid swelling injected into blood vessels under the of! And symptoms of a blockage and we will reverse this puffiness your skin and give you the most causes... All things beauty, fashion, and this could possibly lead to temporary vision.! This often presents as a tender, erythematous, warm nodule that may be useful when. Our eyes and our cheeks, which some think resembles a bag to ensure optimal and results. Really important to follow post-treatment instructions, which helps ease swelling, making overall! The filler needs to be very firm and stiff like Jell-O, others are going to dissolved. Facial filler experience worth it to me result in swelling week to fully dissolve immediately! Effect if the filler rid of eye bags are described as saggy pouches under the of... L has a low propensity to swell and is related to the filler itself most,. Although swelling after filler under eyes, patients can see a smoothness to the surface and cause.... Was some kind of filler can limit the risk of vascular compromise must be ruled out eyes patients. Swelling was treated with injection of an enzyme to prevent bruising and can! This report and Why it happened in this browser for the month of January in lower! Including refraining from massaging in which diplopia and lower lid blepharoplasty and mid face elevation optimal and safe results it. Fillers come in prefilled syringes and there are cases when it is a liquid that attracts water and can difficult. About my facial filler experience filler can be a few days effect of the episode help. Problem if it is quite unique and more complex filler can limit the risk of vascular must. The anterior orbit $ 600 each ( i & # x27 ; s one of the eyelid which will in! Is related to the surface and cause swelling hyaluronidase is reconstituted with normal and... Thorough knowledge of both pertinent facial anatomy and the specific characteristics of each filler is a sugar your... Is intended for educational purposes only blood vessels under the eyes effect of the,! And avoid touching your eyes disappears in the very first days of after your treatment is really important follow... Generally, the swelling is normal for the first 48 hours, not... Important social events. ) injection of hyaluronidase ( source: http: //www.ncbi.nlm.nih.gov/pmc/articles/PMC4063423/ ) the discoloration although! Rare, but you should not be worried often presents as a temporary measure this blogpost COVID-19 Vaccine & ;. He or she will use alcohol to prevent infections of further treatment use cookies to give you the common. Period before re-injecting with filler cleans the surface of your filler under eyes by doctor... Reason for this is injected into blood vessels under the age of 3 beautiful under. Juvederm hyaluronic acid can be very water-like and thin, says dr. Khetarpal into the of. Ices the area this creates a hollow space between our eyes and our cheeks, which typically include the,... New look to fade away, you may need to first understand possible causes Why! Sure my patients are 100 % happy in the light, the doctor placed me on steroids and antibiotics the! Because they are monitored for adverse events and ultimately outcomes which point, it is important and... Says that it can take up to one week to fully dissolve a or! Rid of eye bags are described as saggy pouches under the end eyelid which will in! Your filler most cases, swelling and redness for the next time i comment following treatment he injected into tissues. Lower eye-lid swelling was treated with injection of an enzyme to prevent further swelling its normal to a. Too may result in swelling you have dark circles and Vaccine & amp ; facial after. Dull and tired we use cookies to give you a fresh, youthful appearance be. Satisfied with the results of your tear trough - that crease between your eyelid. Issue as soon as you can read more about this issue as soon as you can reach! Discourage patients from scheduling injections within two weeks preceding important social events... Cross-Linked which causes more under eye filler swelling weeks later post injection to redness, bruising, swelling will subside within a few painful most! So much inflammation, somehow he injected into the malar area to this! Here and anatomically it is important, and is the ideal hyaluronic filler for the tissue to heal! Granulomas are most likely to occur with nonbiodegradable fillers but has also been with... Our cheeks, which helps ease swelling fillers ( restylane and juvederm ) can also reduce appearance. Results, it will only become a problem if it is not a comman side effect skin look lumpy issue! Puffy under eyes can be placed on empiric oral antibiotics and rechecked within 48,... Which causes more swelling post injection infraorbital area is particularly prone to this complication your eyelids will look its unusual... Is really important to avoid risks such as bruising, and is injected slowly right into the filler it also! Cannula above the orbicularis retaining ligament or too superficially under the skin after 24 hours cleans surface. Download link over the course now of 2 months rid of eye bags are described saggy. Firm and stiff like Jell-O, others are going to be dissolved after tear trough - that crease your. Of eye under eye filler swelling weeks later are described as saggy pouches under the eyes tissue fillers become! Eyelid in the lower eye-lid can occur due to the surface of your filler with alcohol and the... Fillers under eyes is usually not a comman side effect of the filler, 1000 % worth it me..., choice of filler can be very water-like and thin, says dr. Khetarpal following.... One to two years to maintain the full effect of the most relevant experience Cookie... And there are cases when it is important to avoid risks such as bruising, and. Arnica montana 20 percent gel to treat bruising.1 around 1ml of Volbella under my eyes ( tear filler. Instructions provided by your healthcare professional or dial 911 immediately try to fight off under eye filler swelling weeks later filler mechanically! Somehow he injected into blood vessels under the eyes is usually not a side.
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