Am I a good candidate for Restylane injections in my tear troughs?
Hello I am 27 years old and have noticed over the last two years my hollows/dark circles
have become more apparent.
I am very fair skin and tend to bruise easily.
Am I a good candidate for Restylane in my tear troughs?
Is so how much would you recommend on each side?
Thank you for your question!
You submitted a photo and you are asking if you are a good candidate for Restylane in
the tear trough areas and you’re also asking how much volume you need in each side.
Well, I can give some perspective.
I’m a board certified cosmetic surgeon.
I’m a specialist oculofacial plastic surgeon which means I focus my practice on rejuvenation
and reconstruction of the areas above the eyes and the face.
And use of fillers and cosmetic surgery to enhance the under eye area is something we
do every day in our practice.
I’ve been in practice in Manhattan and Long Island for over 20 years.
So I’ll give you a little bit about my opinion based on the single photo you submitted.
Now this in the absence of a proper physical examination where when we’re talking about
volume, we should have a sense of dimensionality.
And often, when we do an analysis of patients, we look at both front views, three quarters
view and side views.
But nonetheless, with the one photo you submitted, it appears that you have some puffiness under
both of your eyes and this puffiness is probably what’s further accentuating the depth of
the tear trough area.
Now the question that I always want to answer when I look at patients who have puffiness
under the eyes, before I do the injection of Restylane or any hyaluronic acid (HA) filler
is how much puffiness is there.
How much is the volume?
You see the puffiness is representative of something called lower eyelid fat prolapse.
This means that the fat that’s normally around your eyes, pushes forward and creates
a hernia or herniated fat.
Now in my practice, anybody who has a very small amount of puffiness and is really not
that bothered by that puffiness that much is generally a good candidate for a hyaluronic
acid filler to enhance and soften the transition between the fat prolapse and the valley of
the tear trough area.
You see, if you think about the contrast, the higher the mountain, the deeper the valley.
So, if the puffiness is slight and the valley is not as deep and it becomes something that
is achievable with hyaluronic acid filler.
Unfortunately, a lot of people become a little bit too ambitious and use the same fillers
for people who are very puffy.
As far as volume is concerned, I think it is safe to say that you would probably benefit
from 1 syringe. 1 syringe of Restylane or a lot of other HA fillers is about one milliliter
which is equivalent to one baby teaspoon.
If placed strategically, you can get certainly a very nice result and get even more evenness.
As far as the exact numbers are concerned, that is really something that is hard to estimate
without physical examination and seeing how your tissue responds.
I always try to explain to our patients that when people look for solutions, they often
look for a name of a technology.
Let’s say it’s a machine or an injectable like Restylane but really, it’s the judgment
of the physician and the style and the method and the artistry that makes all the difference
in the world.
It’s often said in surgery that a good surgeon can work with any type of instrument and being
a practicing surgeon for over 20 years, I can certainly attest to that.
The same applies to injectables.
But one of the things that is specific to injectables is it’s also about how the patient
responds to the injectable and therefore, in a case scenario where a small amount creates
a certain amount of swelling, well there’s fluid that also compensates for the volume
of the filler.
So there’s a lot of finesse.
Another take home message is that when you work with the doctor and you feel comfortable,
stick with that doctor.
What I always say that we are like primary care doctors for beauty in our profession.
At least in my practice, that’s how I treat my patients.
So getting to know the individual patients and putting a certain amount, seeing them
and follow up in two weeks gives me a better sense of how they respond and what kind of
volume they need.
Some people need more, some people need less.
So I think at this point, meet with qualified, experienced surgeons is my bias because I
think that a surgeon understands what to do with fat pockets under the eyes as opposed
to a non-surgeon who may be biased by their lack of ability to do the surgery to always
advocate for injectables.
It’s not the nicest thing to say but unfortunately, that’s the reality.
There is a lot of bias and a lot of territorial protectiveness in the medical field and particularly
in the cosmetic field.
So I think the doctor who’s very skilled the full spectrum of solutions to me has the
advantage over let’s say a non-surgeon like a dermatologist who doesn’t do this type
of surgery.
Dermatologist may do other surgeries but typically, they don’t do lower eyelid blepharoplasty.
So I think that finding that doctor that you’re comfortable with and then going through this
process, you’ll learn a lot and be able to answer this question that you submitted.
So I hope that was helpful, I wish you the best of luck and thank you for your question!