Restylane for Lower Eye Lid Hollows

Hi Kidden,

Are you kiddin'?

As we age, we lose volume in our faces. The lower eye lid area and cheek are among the first areas to show this volume loss. It appears as a lower eye lid hollow. The loss of volumes exposes the lower eye lid fat compartments which appear as "bags".

Over the past few years our philosophy of treating the area has changed from removing fat bags, to preserving, and augmenting the hollow area with fillers. The best temporary filler to restore lost volume in this most delicate and unforgiving area is Restylane. The best permanent filler is the patient's own fat (transferred from the abdomen).

It is an area that should be treated only by physician's well trained, experienced, and with knowledge of the intricate anatomy of the lower eye lid area.
By re-inflating the hollow areas, the cheek and eye lid bags are blended into a youthful contour.

The results with Restylane last from 1 to 1 1/2 year. There is some stimulation of new collagen formation so that even when the product is gone, the hollow is not as deep as before your treatment.

Good luck and be well.

Dr. P

As we age, we lose fat in various places. For most of us, this volume loss or 'deflation' generally occurs in predictable areas such as the cheeks, along the browline, in the temples, under the eyes etc. Once the amount of fat diminishes in these areas, what is left behind is a hollowing effect, usually with lose skin overlying the area that contributes to some droopiness.

The remedy for this volume loss is to restore the lost tissue or to plump what has disappeared...in essence to reinflate the area. Fat transfer is an option for facial volume replacement, especially when larger areas are being filled such as the cheeks. Restylane or juvederm are great choices for filling the hollows that occur under the eyes and do not require the added procedure to harvest fat.

Concerns for injecting under the eye include finding an experienced and skilled physician to perform the procedure, avoiding any aspirin or antiinflammatory medications that can cause excess bruising and understanding the possibility of lumps or small nodules could occur in rare instances. If restylane or juvederm are used (hyaluronic acids) then these nodules can easily be dissolved with injections of hyaluronidase.

Overall, the useof fillers under the eyes provides an easy an excellent means of smoothing out the lower eyelid-cheek area and erasing those hollows that make us look older.

Hope this helps

Dear Kiddin,

As you may have aready heard, injections of fillers under the eyes for the treatment of hollowing has become more and more common over the last few years. While the majority of patients undergoing this procedure have a really nice result, you should be informed that some problems can and do arise.

A few things we have seen in patients treated with this procedure include lumpiness as well as a blue hue some notice after being injected. This blue hue arises due to the Tyndall effect, which is the blue light we notice when light is scattered by a colloidal particle like juvederm or restylane.

As to problems with lumpiness, we think that due to the thinner skin overlying the eyelids patients are much more prone to have problems with fillers under the eyes as opposed to in the nasolabial folds and cheeks. The point is we believe that the skin around the eyes by its very nature is more fragile and thinner and as a result, in less experienced hands injections can cause problems like lumpiness. So make sure you talk to whoever you see about their experience and problems they have either encountered or how they avoid it.

I hope this helps.

Dear Kidden

As we age, the fat at the top of the cheek gives away causing the under eye circle. The descent of this fat exposes the lower eyelid fat. Restylane is placed in the tear trough or under eye hollow filling in this void. This reestablishes a youthful lower eyelid cheek complex. Personally, I do not see any advantage of using your own fat for this. Treatment with Restylane will last a year or more and can be done right in the office with almost no discomfort.

It is possible to bruise with the treatment so its important to avoid aspirin and nonsteroidal antiinflammatory agents like advil, and herbal products for about a week before treatment. These treatments are often combined with BOTOX and filler service of other parts of the face. This makes it possible to have an completely non-surgical make over that is even better than the results of facial surgery.