Restylane for Under Eyes

"if the only tool you have is a hammer, everything seems like a nail", is one of my favorite quotes. Today, there is a 2 pronged approach to treat facial aging and there are things that fillers and Botox do that surgery can not do, and visa versa.
While Restylane can improve the bottom junction where baggy eyelids end and the cheek starts, you should discuss with your surgeon whether a lower eyelid blepharoplasty is a better , and more permanent choice. I had a blepharoplasty on my lower eyes when I was 32 years old and it was one of the best things I ever did, other than marry my wife. I'm now 58 and still think it looks good, so realize there is a point at which you may tire of ongoing injections.
I do perform Restylane injections to the lower lid junction and have been happy with the results which typically last about one year. But remember, that you need to be evaluated by your physician to determine which treatment is best for you. One advantage of Restylane is that it can quickly be reversed with an injection of hyaluronidase, if for some reason you were dissatisfied with the result.

Restylane under the eyes is a terrific procedure that instantly gives you the results you are looking for! Patients can expect the results of Restylane to last for about 9 months. The under eye area is incredibly delicate and should only be treated by an expert board certified plastic surgeon or dermatologist who has a lot of experience performing the procedure. 

Restylane is a hyaluronic acid dermal filler that’s
associated with excellent clinical results and high levels of patient
satisfaction.It’s easily injected and
has a smooth soft presentation.Restylane is very versatile and can be used in multiple anatomic
locations.When the eyelids are treated
it’s important to be cautious for several of reasons.In this area the anatomy is very complex and
the skin is very thin.It’s
important to place Restylane below the orbicularis muscles when treating lower
eyelids.Superficial injections can be
associated with several problems.These
include lumps and bumps which are accompanied by a bluish discoloration of the
skin.In some cases, there may be a
diffuse bulge in the area of the lower eyelid form expansion of loose lower
eyelid skin.Superficial injections in
this area are often painful despite topical anesthesia which is usually
effective.Restylane
typically last about 6 to 9 months, but when the eyelids are treated it may last
for 12 to 15 months.If
you’re considering lower eyelid Restylane injections it’s important to consult
a specialist in this area.This
specialist should be able to formulate a treatment plan that addresses your
concerns.

Someone with significant aging of the lower eyelid is best treated with a surgical lower eyelid blepharoplasty which I perform often.  However, for the patient, with minimal lower eyelid aging, Restylane injections to the tear trough or lower eyelid can do just the trick.  I like to inject this hyaluronic acid gel here as it blends the lower eyelid/cheek junction well.  I prefer to utilize a blunt microcannula to inject Restylane here as I can do it safely with no bruising.  I may perform one or two treatments in the first one to two months and see results that last 6-12 months.

It depends on technique and your metabolism and if it is placed below or above the muscle. The range is from as little as four to six months and up to a year or more.

I can often get very nice results with Resylane injections underneath the eyes (usually placed in the tear troughs). I will sometimes combine it with either laser tightening of the lower eyelid skin or a chemical peel to get even a nicer result. This can usually be done in one treatment, and usually lasts a year or longer.
This is an advanced injection technique so I would recommend going to someone in your area with experience in using Restylane in this manner. Ask to see their before and after photos and make sure they're comfortable with this, otherwise the results can be poor.
Good luck!
Dr. Salemy

I have found that restylane lasts longer than a year in some of my patients.
In general, I tell my patients to expect a touch up at about 9 months. However, most patients end up not needing a touch up, or any further injection until approximately one year.
I have also noted that there is less swelling with Restylane than other hyaluronic acid products in this area.
Good luck.

1.5 cc of Restylane for the tear trough region is much more than average and probably more than most patients need. Most patients do not require a full 1 cc syringe split between both eyes. The most recent consensus statement in Plastic and Reconstructive surgery details the use of hyaluronic acid in different areas of the face and fully supports my statements.
Although some patients will have Restylane last more than 1 year in the tear trough region, the length is variable. I agree that hyaluronic acid will last longer in the tear trough than the nasolabial fold. Most physicians attribute this to less movement in the tear trough than the nasolabial fold.

Restylane under the eyes is usually done in one procedure, however occasionally a touch up may be necessary, but usually not planned.  Restylane in the lower eyelids usually lasts around 12 months in our experience, but not in everyone. 

Dear Mother's Glow
For many physicians injecting into the under eye area, they simply don't understand the anatomy and are very timid with their injections.
My advice for these doctors is: If you are uncomfortable with the anatomy-please don't do the treatment. If is much better for everyone if you refer your patient to someone who really knows what they are doing.
Medicis, the company that makes Restylane, finds that most physicians on average are using just a 1 milliliter syringe to treat all the areas of the face per session. This means that very little volume is actually placed in the under eye area.
In my practice, the average under eye circle treatment is 1.5 ml of Restylane in each undereye area. A total treatment is typically 3 ml of Restylane. The longevity of these treatments is well over a year. Treatment is surprisingly comfortable.
These is a 20% chance of bruising and a 2% chance of actually having a black eye. It is best to think of this treatment as surgery in a syringe. Avoiding herbal products and medications like aspirin reduce the risk of bruising. The results are without a doubt much better than what can be accomplished with surgery.
It is best to get the right amount of treatment at the time of initial service. If there are any lumps or bumps, these can easily be adjusted with Restylane either with direct message or with shaping using hyaluronidase, the enzyme that softens Restylane.