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Under Eye Hollows/tear Trough Treated with Fillers

I am 28 and I developed rather severe tear troughs...

I am 28 and I developed rather severe tear troughs when I started work, they developed over the course of two years. My face has changed since working on the computer all the time!

The doctor explained that the problem needed to be treated with a two-phase approach, the first phase was to treat some of the volume loss in the front of my cheeks (where I am naturally quite flat anyway).

She injected 1ml of Perlane deep into the tissue using a multipoint innjection technique. It hurt a bit but I didnt mind it, I had ice, it seemed to help a bit. Not bothered by the pain as it is so transient! It swelled up quite a bit but this went down after the first three days, then even more after two-three weeks. This had an amazing effect on my face. It felt like it lifted everything. I would like to get more here in the future, as now that the swelling has gone down I miss it a bit - (the filler still has a great effect, just not as much as the initial couple of days, where it lifted my minor jowl shadows. I had some bruising but it was yellow in colour so could hide pretty easily with makeup . The bruising was gone in a week.

The second phase was when she injected restylane into the actual tear troughs, which she did one month later. She used a multi injection technique (not threading). The result was super smooth result. This bruised worse - I had a dark bruise on my left eye - without makeup it looked like I had a little bit of a black eye. I didnt care too much about this, just wore sunnies and concealer.

I was advised that the Perlane would last 6 months, and the restylane about 3-4 months.

My eyes bags are completely gone I am so thrilled with how it looks! I told a few close friends and they were excited and want to go see my doctor. I those that dont know have made comments like "oh my god you look so refreshed" and "Now that you are not so stressed about 'xyz' you look so much younger!" ... It has been 2.5 months now since my intial treatment, and the results still look great! I would highly recommend this to anyone contemplating it. I am in Melbourne.

Name not provided

Find yourself a good doctor. My doctor is a plastic surgeon, she has specialised in this field her whole medical career and has an unblemished safety record. It does not cost much more to go to someone really good. Its worth it!

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Thank you thank you for this information! I have been looking for a dr in Melbourne who does tear trough solutions with filler. And as you can imagine I am a bit apprehensive about getting it done due to reading many reviews on the internet of where it goes wrong.
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Thanks for the responses. At my age, what risks are involved with doing temporary fillers? I know about bruising, but I've also heard about cysts forming. I've been considering having Prevelle injections as a "starter" filler, just to see what it looks like. Then I'll move on to a longer lasting filler. I probably won't be putting that under my eyes though. Most likely I'll use restylane for the eye area.
Also, do fillers lift the skin? I've recently developed major sag in my skin and huge dark under eye circles due to Rogaine use (caused severe hypotension).
As for fat transfer, that was my second choice. I've seen some pretty good facial fat transfers (Dr. Karam in San Diego) as well as successful fat transfers to the breast where the after pictures were taken 6 months - 3 years post procedure (Dr. Khouri at Miami Breast Center).
I also had massive facial fat atrophy happen to me from a miscommunicated radio frequency facial (was 23 at the time with all of my nice baby fat). This procedure was meant for more mature adults who've lost their baby fat and want to tighten jowls, etc. and instead it completely obliterated my supple cheeks to the extent that I looked like I just returned from a concentration camp. SO that is my story and the reason why it is important that I do something quick, before I lose anymore elasticity.
Is there a grace period from when first you notice sag or wrinkles in the skin to the time when they become permanent and no longer able to be treated?
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Hi everyone. I've been injecting undereye areas for many years now and have never had anyone develop cysts in the skin. If your aesthetician has worked in the Ukraine during the 1990s it is possible that the treatments were not done with hyaluronic acid products. Restylane was only commercially released in the late 1990s, Juvederm in the early noughties (I think). In the 1990s collagen and Dermalive and a whole stack of now-banned fillers were commonly used. Fillers like Artecoll and Dermalive have caused thousands of complications/ eg granulomas back in the 1990s.
If you are in your 20s think carefully about your treatment options. Hyaluronic acid products are only temporary but that means they have a greater safety margin than so many of the older products. We have a little saying in the field of Cosmetic Medicine: Permanent fillers= permanent problems. Not in every case, granted, but do you want to risk it at all when you're only 20 or 30yo? I definitely wouldn't! Safety should always be the first consideration, regardless of the cosmetic problem.
Oh, and fat transfer is a waste of time since most (70%) of it dies within 3 months, and there is a huge risk that the remaining 30% will take better on one side than the other..meaning that every time you gain or lose weight, your face will (asymmetrically) as well!

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Not sure about being able to post links. I have heard that with regular use sometimes you do not need them in some areas anymore as the body forms it own collagen. I will look forward to reading anything you have. You can PM me if you want.
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Thanks for the reply. My esthetician worked as a dermatologist in the Ukraine for 13 years and once she came to the US worked as an esthetician. She mentioned that when she does facials on clients who've had fillers, she always feels the cysts that are built up in their skin, even though they look fine. She could have simply been making an intelligent guess based on what she has felt, combined with her scientific background. Fillers, such as juvederm and restylane, have been around since the mid-90s I believe (quote wikipedia). I've come across one scholarly article with regards to the negative long-term effects, but I'll have to dig it up. Are we allowed to post links on realself?
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I, too am a patient of Dr. Teska's. I will ask her what she thinks about long term fillers. I am not too sure though what your esthetician is basing her statement on. Have fillers such as the ones we use now been around that long??? Is she a doctor? I also would check the "scholarly literature" if you have access to this. I have not done so, but it may yield some answers.
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Hi,
Not sure if you check these posts, but I'll write anyway with the hope that you'll respond. Out of curiosity, how has been doing fillers under the eyes long-term? I'm 25 and my esthetician said that if I start now, I will look like s*** in the future (crass, yes but quoted directly). I think she is mainly referring to the development of cysts though. After the continual procedures, have you noticed any changes in your skin texture, elasticity, or youth under your eyes from the injections? I really want to use them but I am deathly afraid of what could possibly happen in the future...
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hi sadar
i have very hollow eyes and maybe worse than you. i checked with a doc and he didn't recommend to me fillers such as restylane and juvederm, ( he said that my under eye skin is so thin ), so he recommended fat transfer ( from my thigh ) and i am quite dpressed, frustrated and anxious, and i don't know what to do, i am afraid to do dermofillers and have them overdone, or make the biofiller ( from my own fat ) and have it a very bad look. please any one can help me in this? i need to take my disicion. thanks
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Hi itani81, 

You might want to check out the Fat transfer community, it might answer more of your questions. 

Thanks,

-Britt

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Are you in a major city? You should really consult with more than one doctor to make sure you aren't a candidate for fillers. I have very thin skin as well and though I had a ton of bruising, I loved the results of restylane after about a month. You really want someone very experienced with fillers in the tear trough area. Also, outside of the US there are options besides restylane and juvederm you could look into.
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Dr Teska placed the tear trough filler under the muscle, it was placed quite deep, so the filler wasnt up near the skin, it filled it smoothly and you cant tell its there - maybe you could find a doctor who could do this for you if its suitable? Id say def get a second opinion.
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Thanks for that info. There are many people out here who will be thankful. Glad to hear the treatment still has your blessing.
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hello everyone this is sadar2 - back after a long time away from this site....

just wanted to let you know where you can find dr teska - her clinic is called skin temple med spa clinic. the link to the website is www(dot)skintemple(dot)com(dot(au)... sorry not sure i could post links on the forum.

to update - its now well over two years later and i am due for a touch up to the restylane under my eyes - i have since had some sub q in my cheeks once, and more recently some juvaderm in the cheeks - this stuff really does last a long time, and its true that you need less and less over time.

Dr Teska told me she has been receiving inquiries from people on this website but is unable to respond to emails due to restrictions on the website - please email her (go to her website and email her from there)... that way she can get back to you.

:)
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btw the whole treatment - the cheeks and the eyes is about $1200 Au dollars - i made a mistake initially when i stated the cost. sorry i think i was trying to change the cost into US dollars when the au dollar was lower than US.
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That's fantastic news! That makes me much happier about the procedure because I can't really have any downtime and the mothers would assume terrible reasons why I have black eyes at school pick-up! Dr Teska what is the best way (via public transport) to get to your clinic? Kind regards, Adrienne.
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Just an update to let you all know that with the arrival of blunt ended micro-cannulas, the 2nd stage of this treatment is now being done primarily with a combo of Esthelis Soft, injected with a micro-cannula. Just one prick per cheek!!

Micro-cannulas are far less traumatic to the delicate under eye skin, and can be used safely to treat hollows without the risk of bruising..a major deterrant for those who can't risk the downtime of a bruise!!

We are loving the micro-cannulas so much that we're also using them for the injection of other fillers in the lips, and they are absolutely wonderful for Sculptra treatments to the lower face and temples..another product usually prone to cause bruising.
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I've got a review I'll post up in a couple of weeks about my experience with Dr A Teska.
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Thank you for that information, I have been looking at your site. That is an interesting comment you made about Restylane and the under eye area. I have just finished reading Dr. Kenneth Steinsepir's site and he promotes the use of Restylane under the eyes... Can I ask you what you feel are the long term cosmetic problems?
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Sadar2, great job but one comment, your doctor is not a plastic surgeon. I go to her as well - she's fantastic, especially with fillers. Makes you look very natural and refreshed!
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Thank you for that added recommendation. I will check out your doctor when I am in Melbourne. It is so difficult to find a doctor who can inject without making the female face take on an almost masculine look. I had fillers in the summer in the UK and I ended up with a square face!
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I live in Tasmania, and have similiar problems and others due to a dodgy surgery job done here. Would love the name of your surgeon so I can see if she can help me out...thanks in advance
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Read the post from Adie23 above mine re: under eye hollows for the doctor's name.
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Hi everyone

I have just got back onto this website after a long break. Sadar2 replied to my post. The doctor's name is Dr Alicia Teska. Her new clinic look beautiful and I hope to have the procedure done sometime this year.

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Thank you so much for sharing this information with us. Please let us know how you get on with the treatment.
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Yeah, it is pretty lame that she didn't give her doctor's name after such a great result. But with only the single post on the site over a year ago now, it looks like for whatever reason no one will ever know! How many female plastic surgeons in Melbourne who use a Perlane/Restylane combo under eyes can there be? In my experience not very many plastic surgeons personally perform or "specialize" (as she said) in injectables, especially tear trough. Maybe someone who's commented here has called around?
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