Dear Conscientious Injectee, You have valid concerns. I have been injecting fillers for over 13 years and one thing that is certain is that there is variability in how long fillers will last in any one area and for any one patient. The eye area is one area in which fillers last the longest. Fillers in this area "can" last over 2 years, but there is no guarantee on that. (Unless the injecting doctor wants to guarantee that). I would not feel comfortable making that guarantee. In the under-eye area (infra-orbital or tear trough region), no filler is FDA approved to treat this area, so we can not say with 100% certainty how long a given filler will last based on a well controlled trial. We have to rely on our experience. With that being said, what I tell patients is: 1) We have to get the right level of correction. This could mean more than 1 treatment to get you to full correction. Most often, I will treat a patient with 1-2 syringes of fillers and then re-evaluate at 1 month. Some patients will need more at a month. At times, I will layer different fillers on top of the first treatment. 2) Filling Adjacent areas to create an aesthetically balanced and pleasing end result. Many times, the cheek needs to be corrected to help support the under-eye area. Treating the cheek can go a long way to correcting the under-eye area, but often, a true under-eye treatment is needed for ideal correction. 3)What filler is used: Some fillers last longer than others. Vollure can last the longest but some patients have had prolonged or delayed swelling from this product. I personally have not experienced this, but it has been noted by others. So to summarize, yes, fillers in the under-eye/tear trough region can last up to 2 years, but this is highly variable. I prefer to treat to correction, reevaluate at 1 month and fill more as needed and then follow the patient along. This minimizes an over correction and allows for the most natural look as the under-eye is one of the easiest areas to over correct. Then the patient is treated on an as needed basis. If the patient feels they need more at 6 months and I agree, I retreat at 6 months. If it is a year, then we treat at that time.
