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Dr. Nayak: Alright, so we're here with Danielle, and Danielle came in with, um, pictures from a few years ago where she just said, what happened? You know, we're... what looks different? And, um, in my opinion the thing that looks the most different from today versus a few years ago is, she was just a lot softer looking, and a lot, um... fuller-looking a few years ago.

And so, today, what we've done so far, we've actually filled her left side, and we, we missed in on the camera reaction, but it showed it to her in the mirror and she said, oh, my bag's gone. So... we actually filled the left side under the eye. My strong preference for that is Restylane incendie. If we ever see ya in person we'll tell you about why.

And in the cheek area, we've actually rebuilt the cheek area as well. And my strong preference for that is Juvederm Multiplus. Now we can go ahead and do this side. And we did this with the Cannula technique on that side, and it only took one needle stick. And so the fewer the needle sticks, the less the chance of bruising, so that's always really nice.

We're going to do this side, and the goal on this side is to bring this shape... relax your eye up there for me... back... and soft like that. And that's usually how I simulate it in the mirror before we even start the filling process, to make sure we're all on the same page as to what we're gonna do. So rest your head back there in the pocket there, Danielle. Chin down just a little bit. And gonna get started on this side. You ready?

Danielle: Mm-hm.

Dr. Nayak: Okay, good. One little poke. One, two, three, poke. Sorry. Now we're using Restylane. Eyes up to the ceiling. Restylane is by far my preference in the tear trough proper. And this instrument's called a Cannula. It bruises tremendously less... than needles do. I've been using Cannula in general many months now, and under the eye, probably four or five months. And it's very natural for us, because when we do fat transfers we use a very similar instrument. And, uh... the other nice thing is that it's pretty painless. Would you agree? Mostly don't feel it?

Danielle: I don't feel anything.

Dr. Nayak: Yeah. So the fewer the needle sticks the better the procedure is. Alright, so things are going well. We've done the inner corner of the undereye, and we're going to go ahead and work into the outside portion of it into the cheek. You okay?

Danielle: Um-hum.

Dr. Nayak: This is the last bit, you'll be done. And so for our viewers there, it was one syringe a Restylane and two of Juvederm is what we ended up using. Um... I believe in trying to get people really good results. So generally when I do three or more syringes... I basically take a little bit off the price so we can use enough to make a difference, rather than just doing a couple and not makin' a change. That looks great, so we'll peroxide swab, we'll let ya see, okay?

Danielle: Perfect.

Dr. Nayak: Take a look. This time we'll get it on camera, you can actually see.

Danielle: Oh my god. There's no more bags.

Dr. Nayak: Isn't that crazy?

Danielle: High five.

[smack]

[laughter]

Dr. Nayak: Alright. So that's, that is interesting. That is almost always the reaction we get with injectable fillers under the eyes. Wow, we hear that all the time. We've heard it in Japanese, we've heard it in English, and... where are you from?

Danielle: New Jersey.

Dr. Nayak: We've heard it in Jersey.

[laughter]

Thanks. Thank you so much.

Tear Trough Filler For Nonsurgical Lower Blepharoplasty and Midface Lift

Dr. Laxmeesh Nayak demonstrates his cannula technique for injectable filling of the tear trough, midface, and cheek.

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