Scarsdale Dermatologists

Why is It Difficult to Get Good Results for Bags Under the Eyes with Juvederm?

What are some of the problems with Juvederm filler for bags?

Juvederm and Restylane, the hyaluronic acid fillers, can be used to fill under eye hollows, but this must be done with extreme caution. Swelling, bruising, and visible lumps or filler material are higher risk in this area than other areas of the face. If filler is injected too close to the surface in too great a volume, a blue tinge can be visible from the effect of seeing clear material through the surface of the skin. This is the Tyndall effect (a name from physics that has to do with the light refracting through the skin making it look blue when the stuff is really clear). Each of the hyaluronic acid fillers absorbs a different amount of the body's natural water once it's placed under the skin. This can either be a great advantage, or a disadvantage, if the material is not well understood by the physician and is used in a less than ideal way. Juvederm tends to absorb more water than Restylane, and this absorption is long lasting, so unlike the normal swelling that does go away after any injection, the doctor should be cautious and not overfill with Juvederm, since water absorption by the material is greater than with Restylane. A good result can be achieved with both.

Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

Is It True That Dysport is a Lighter Toxin Compared to Botox?

If so, what are the advantages of this? In what circumstances do you prefer Dysport to Botox?

Dysport and Botox are brand names that represent different version of the same basic underlying toxin molecule. This protein attaches to the junction between nerve and muscle and blocks muscle activation, leading to weakened muscles. Some people do respond better to one or the other, and some respond well to both. Some people don't respond so well to either. If you like the one you've tried, there is no real reason to try the other, but if the one you've used did not give an ideal result (wore off quickly, etc), it is ok to try the other. Make sure you are seeing a GOOD, well-qualified injector who knows how to use both well, so you can be sure that your results are because of the substance used properly, and not questionable because of the injector.

Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

Botox Under the Eye for Lines and Crow and Now I Have a Bags and Deep Line Under the Bags- Now What?

I had botox for crows feet and few lines under the eye area now after 5 days I have bags and a deeper line under the bags.What should I do.I have put ice on because there was swelling at first.Now the bags and under the bags a deeper line.This was done by my Deromotolgist that I have been going to for 5 years with no problems.What do you suggest?

Unfortunately, having increased under eye wrinkles when Botox (or Dysport) was used on the lower lid itself is not an uncommon problem. Botox only works by weakening muscles, and the skin under the eyes is very delicate and susceptible to overweakening of the muscles there that hold some appropriate tension. I personally would recommend you do not have your dermatologist add hyaluronic acid filler to the area, because that could last up to two years, while your Botox, as unsightly as it may be right now, will wear off in a few months.

Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon