Lancaster Doctors

Dark Circles Sunken Eyes - Are fillers a viable option?

im in my early 20s and i have had dark circles, and sunken eyes for a really long time. would fillers benefit me. i want to start a career looking my best as well feeling it. what treatments are good for pigmentation.

Hi James,

It is difficult to offer any advice without any photos or seeing you for an evaluation. I would recommend a consultation with a facial plastic surgeon, plastic surgeon or dermatologist in your area who can evaluate your skin type and tell you which treatments would suit your skin. There are some prescription-strength creams and great laser options for pigmentation, but they are only safe in certain skin types, so it is important that whoever you go to evaluates your skin properly and recommends a suitable treatment. Sometimes what is perceived as under-eye pigmentation is really the dark orbicularis oculi muscle being visible through the translucent skin of the under-eye area. In this case, a laser or cream would not help.

Often, fillers can be a good option for some, but not all, people with under-eye hollows. Again, this is why a consultation would be beneficial to make sure that your facial anatomy would lend itself to improvement with filler.I hope this helps.

Dr.Sunder

Sarmela Sunder, MD

Beverly Hills Facial Plastic Surgeon

Will I Be Wrinkled and Scarred from Having Tear Trough over Filled and It Getting Infected?

Concerned about my eye area looking dull,dark,sunken and feeling aged from it. Im 44. Decided to have tear troughs done. I think my eyes were over filled as for months, ive been battling with puffy and discoloured eye area after done. Sadly, no good days. Slowly, it is disappearing, leaving me with what appears to be small pockets of filler, but it going down unevenly, making the skin appear wrinkled and like its stretched. Will this improve as time goes on, as it was not at all like this before

Hi,

It is difficult to make any comments without seeing you in person or without photos. My recommendation would be to return to your injector and express your dissatisfaction. The product that was most likely injected was a hyaluronic acid product (Restylane or Juvederm). You can consider having your injector place hyaluronidase into the area where the filler remains. Hyaluronidase will dissolve any remaining product that you may have in the tear troughs. If you were happier with the way it looked prior to the filler, then the you should consider having it removed with hyaluronidase. I hope this helps. Good luck!

Dr.Sunder

Sarmela Sunder, MD

Beverly Hills Facial Plastic Surgeon

Facial PS Says No to Nasolabial Folds, and Instead Injects into Cheeks, Is this a Common Approach?

I visited a new facial PS as I wanted my tear troughs filled, and this isn't something my general PS often does. I also wanted filler in my nasolabial folds. My new PS explained that his approach to nasolabial fold filling had changed in the past year, and he now avoids it. Instead he injected quite a bit into my cheeks which did pull up the fold and created a younger, more round-faced look. I'm mostly pleased with the result, but it cost a lot more. Anyone else share this perspective? Why?

Hi Danielle,

I often tend to fill the cheek or mid-face region to soften the folds, rather than fill the folds itself. The reason most people have the folds in the first place is because the the fat (and volume) from your cheeks has descended. So you are left with a lack of volume where your cheekbones used to be, but all that volume is now sitting closer to your mouth, immediately above the nasolabial folds, which creates these deep folds.  If we then put filler into the nasolabial folds, we are just making the area around your mouth look even fuller and not even addressing the fact that your mid-face and cheek region look shallow. This fullness around the lower face and lack of volume in the mid-face is what leaves people with that "bull-dog" appearance. In my opinion, it looks very fake and is a dead give-away that someone has filler in their face.

Instead, by using filler to recreate and restore volume in the cheek, I am able to make patients look much more refreshed and natural-looking than if I were to only fill their nasolabial folds. In addition, depending on the product that is used, the extra volume in the cheek can actually "lift" the folds a bit to make them appear softer and less deep. There are cases where I have filled a patient's nasolabial folds after I have filled the cheeks. However, it looks much more natural and they often need less product in the folds than if I had not filled the cheeks at all. 

In addition, I have noted that filler placed in the cheek generally lasts longer than filler placed in the nasolabial folds. So, while it may have cost more to fill the cheeks than the folds, you will probably not need to maintain it as frequently. I think your facial plastic surgeon really understands the dynamics of facial aging and gave you good advice. I hope this helps!

Dr.Sunder

Sarmela Sunder, MD

Beverly Hills Facial Plastic Surgeon