Treatment Provider

Tanuj Nakra, MD, FACS
Oculoplastic Surgeon, Board Certified in Ophthalmology
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Like many approaching 40, I've noticed with some...

Like many approaching 40, I've noticed with some disappointment that I've grown increasingly tired-looking- regardless of whether I'm well-rested or hydrated or not. The culprit- the growing dark circles beneath my eyes. Yet for me, the idea of lower-eyelid surgery to correct the issue seemed a little too extreme. I was put off both by the invasive nature of the procedure and the prolonged downtime. So I remained in a holding pattern- reading accounts here of user experiences with lower bleph (and other treatments).I began seeing more and more positive reviews of Restylane injections in the tear-trough area to correct the problem- which prompted me to further reading on that specific procedure. Before and after photos here and elsewhere seemed to suggest that- on the whole- the procedure worked pretty well. Occasionally, I'd seethe nightmare account of an injection made by an inexperienced or overzealous dermatologist or nurse or quack- which gave me pause. Even though those seem to be the exception, and rare, they were still pretty intimidating. So I remained on the fence for several months.I eventually mustered up the courage to go talk to an Oculoplastic Surgeon about the procedure- after reading through the very enthusiastic accounts of an LA-based Oculoplastics specialist who- (here and elsewhere)- described Restylane for tear-trough hollowing as the greatest thing since sliced bread... If a guy who specializes in cosmetic eyelid SURGERY is pitching a cheaper, less-invasive procedure (regardless of where his bread has historically been buttered)- that should mean something. That his before/after photos seemed pretty amazing further put me at ease.So I went about seeking a local Oculoplastic Surgeon- figuring that if I was going to have a needle go under the skin near my eyeballs, I'd prefer the person putting it there know exactly what is going on BENEATH my skin.I received injections last week. The procedure itself was more uncomfortable than I expected. I had received numbing cream and felt little pain- but the physical pressure, and the periodic sounds of skin being punctured (particularly when it was done from within my mouth), took a little time to get used to. Immediately following the procedure, I got a look in the mirror and felt, frankly, apprehensive. That my face had changed was pretty obvious to me- but I looked far more swollen than I had expected I would (even though I only had one syringe split between two eyes). The doctor felt the procedure had been successful- which was encouraging- but I couldn't help but feel apprehensive. My cheeks looked puffy and red.Within 24 hours- some of the puffiness had gone away. And- to my delight- it became clearer to me that the procedure had had a positive benefit. The darker rings below my eyes were largely gone- the color of the skin there looked healthy and plumper (without looking like I was bloated).It's now been a few days. My bruise remains- but is fading. The swelling has largely dissipated- though my face is still not back to its former shape. I expect within a week or two, the bruise will be gone- and perhaps my face will look as it did last week- except without dark rings below my eyes.Overall, my experience was extremely positive- and I would rate my results, on a 1 to 10 scale, as an 8. I do not know how long these results will last, but if the last a year, I will definitely consider the procedure to have been more than worth the money. I can only speak for myself, but I will say that I am extremely happy that I went to the effort to seek out an Oculoplastic Surgeon for the job. His lucidity on the subject of under-skin anatomy of the face/eye/tear-trough region really made me feel in good hands. It felt- in the event something DID go wrong- I'd be in the hands of the best possible person to diagnose and address the problem. That knowledge- and his candor- made me worry less than I might otherwise have. I hope this account is helpful to the next person out there who is considering this procedure.

Provider Review

Oculoplastic Surgeon, Board Certified in Ophthalmology
3705 Medical Pkwy., Austin, Texas
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Overall rating

As I noted in my review, "My Dr's lucidity on the subject of under-skin anatomy of the face/eye/tear-trough region really made me feel in good hands". He was extremely patient with my questions. When I had run out of them and I asked what else I should be asking- he did not hesitate to suggest that many patients asked about "worst case scenario complications"- and then he listed them. He mentioned having read a medical account of blindness resulting from a direct injection into a blood vessel- though he had never seen this happen and didn't know a physician who had. He also mentioned a case of skin necrosis- I think from an artery injection- but again noted it was extremely rare. That he was so quick to speak of the worst-case scenarios- however statistically unlikely they are- greatly impressed me. He could have easily ended the conversation without a mention of the rare but nevertheless serious risks- and I wouldn't have noticed the difference. I appreciated very much this kind of honesty. Though I was pleased with the results of the procedure- it was because of his *candor* that I opted to write this review.