Restylane - Gone in 5 Months?

    If you are going to have a facelift in two years, you can just stick with the Restylane in the tear trough area.  You should consider fat grafting to the all of those areas at the time of facelift.

Combining Belotero Balance With A Little Radiesse Works Well For tear troughs, hollows, and dark circles under the eyes. It has been my experience that Radiesse, owing to its whitish color and more robust nature, can help to lighten dark circles and enhance the durability of the response--i.e. duration of the clinical results. While I routinely tell patients that the benefits may last about a year, I have had quite a few patients that have gone for several years before requiring a touch up, particularly when I combined a small amount of Radiesse with Perlane. 

Tear troughs, hollows, and dark circles are common problems of the lower lids. It has become standard practice to treat this region with lighter fillers, like Juvederm or Restylane, to lift, straighten, and contour this region. These relative "light weights" tend not to last as long as their counterparts, Juvederm Ultra Plus and Perlane, respectively, or Radiesse, which is calcium based.

Occasionally, if hyaluronic acid fillers are inadvertently placed too superficially, a bluish discoloration related to light scattering (a phenomenon known as the Tyndall effect) can occur, which can actually make the dark circles more prominent. Belotero, a new hyaluronic acid product, has been manufactured to avoid this.  As has been pointed out, Sculptra is not a permanent filler, and I would not recommend permanent fillers, such as silicone or Artefill, be used in this very delicate, visibly prominent, and cosmetically unforgiving region. Only an experienced, board certified aesthetic dermatologic or plastic surgeon injector should be sought to treat this region.

Volume restoration of the face for facial rejuvenation is now commonly accepted. Fillers are now commonly used to rejuvenate all areas of the face.  The most commonly used classes of fillers in the US include hyaluronic acids (HA's-Restylane, Juviders, etc), Radiesse, Sculptra.  There are many more that are used abroad and a few new ones that are slowly gaining acceptance.  Each of them performs slightly differently and work well in certain areas of the face.  The HA's work well in the lips and around the eyes where the tissues are thin and lumpiness can be a problem.  They also are easily reversed. Radiesse is a good sculptural filler and works well in the cheeks and nasolabial folds.  Sculptra is a good choice for those who want a gradual improvement over a longer period of time.  These fillers all last for 9-12 months in the face except in the lips where the HA's tend to go away in about 5 months.   The HA's also tend to last longer around the eyes.  If your fillers were gone in 5 months, it is probably as a result of undercorrection.  It is atypical for these fillers to resorb within 5 months around the eyes.  If you have had an excellent result and were pleased, it is reasonable to continue.  Their use should not have any future effect on plans for a surgical procedure such as a facelift.  Best of Luck!