I have sunken in, dark circles under my eyes and a filler sounds like the best solution for the problem. Restalyne seems to be the most recommended, but Juvederm and even Radiesse seem to be recommended also. I have, however, read about disastrous results due to allergic reaction. I want to know if the patient can be tested for allergy to the filler and whether there are any other preventative measures available. I need this treatment but I am scared of these side effects.
Can a person be tested to see which filler is right for tear trough?
Doctor Answers (6)
Treating tear toughs, testing?
Hyaluronic-acid based fillers are terrific for treating the tear troughs, not only because they are incredibly safe in well-trained and experienced hands (e.g. dermatologist), but also because the results are reversible if there is a problem or you're not happy (generally quite rare). Restylane is my treatment of choice, although Juvederm is good too in this location. Some people are great candidates for this treatment while others don't benefit from fillers under the eyes, so make sure to pick a physician you trust and who has the training and experience for treating such a delicate area.
Allergy Testing To Hyaluronic Acid Fillers Possible But Not Necessary Before Treatment.
It has become routine practice among experienced injectors to treat dark circles, hollows and tear troughs under the eyes with hyaluronic acid-based fillers. Hyaluronic acid is a natural sugar-based substance that is found in abundance in the skin and cartilage. As such, the likelihood of allergy to these fillers is extremely rare and for this reason, no regulatory agency in the world requires allergy testing prior to aesthetic treatment with any of these products.
That having been said, I have on rare occasion, for individuals who express great concern, performed allergy testing using a tiny amount of the product injected in the forearm (analogous to the way a PPD tuberculosis test is done). To date, no patient has tested positive to the test amount of material, and I have been able to treat all patients that I have so tested.
Belotero Balance (excellent for the thin skin under the eyes since it does not cause the bluish Tyndall Effect) and diluted Restylane are my personal favorites for under the eyes. When dark circles are present, I also add a tiny amount of Radiesse, a whitish colored calcium-based (also natural) filler, to help lighten the skin. Radiesse should not be used as the primary filler in this region since lumping is possible when this is done. And of course, if the patient so wishes, an intradermal allergy test can performed in the forearm with a highly diluted form of this injectable, as well.
IIt usually takes about five minutes to treat each lower lid, and the results are immediate, typically evoking a "Wow!" response from the patients when they look in the mirror.
While minimal bruising, tenderness, swelling and redness may occur following treatment in this delicate region, these are usually temporary and disappear spontaneously within one to seven days. Most people can return to work or social activities immediately or the following day and may use makeup if desired.
Best filler for tear trough
As with most of the comments to this post, I also usually recommend either Restylane or Belotero for the tear troughs. Juvederm can sometime absorb too much water and cause a puffy look in this area that can be seen through the skin. All of these are hyaluronic acid based fillers. Radiesse is a calcium based filler, which is thicker an not recommended for under the eyes by most doctors or by the company. Hyaluronic acid is a substance found in our skin and tissues, so allergy testing isn't typically performed. Most important, is that you seek out a reputable and experienced physician to perform the injection as proper placement of the filler is key.
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Tear trough fillers
I only use Restylane for tear troughs. Juvederm can sometimes show through the skin. Radiesse is too thick. I would definitely not recommend it for tear troughs. Injecting the year troughs is tricky. Pick your injector carefully.
Restylane for tear trough
I prefer diluted restylane for the tear trough to blend in nicely with the thin tissues. Best to be seen in person.