Dermal Fillers

Profhilo

Hello there! Fillers are a wonderful volumising tool! Understanding there exact metabolism is quite variable and largely based on clinical judgment (guessing) and averages. In practice, a good high-quality dermal filler (like restylane) should integrate with your own tissue and become part of you. This aligns with more natural outcomes to both see and feel. Patients often may feel that they "Burn through filler" but this is not likely the case, largely when one can no longer feel a mass of filler, they believe it to be gone. But when we use tools such as ultrasound we can often identify the filler still residing in the tissues. Apologies for getting a little long winded and scientific. In your 1st photo day one post treatment, we can see a great deal of inflammation and bruise which adds to the volumized appearance, a photo 3-4 weeks post-treatment is a much better indication of the final outcome. Because after this amount of time inflammation will have settled and filler will have integrated. 
I would like to add that, form the photos, you have beautiful features to your face. I would recommend a consult with an aesthetic doctor focused on skin quality treatments first before re approaching dermal filler options. Skin tightening (morpheus8/facetite), retinol, Profhilo are all excellent options that improve skin quality and will emphasize your naturally beautiful bone structures etc. after skin quality treatments volume replacement for stubborned areas could then potentially be sought out...if needed.
hope that helps 
Dr Dallas Walker

First photo day of filler treatment 2 years ago. Second photo is current. I was happy with the results, but they only lasted 4 months. I was told it would last a year to 18 months. It was so expensive for it to not last longer.

Any hope for those who metabolize fillers too quickly? I spent a few thousand dollars for restalyne and lasted only 4 months.

Hello there!
The under eye area can be such an annoyance for people. What I can see in the photo looks largely like a collection of lymphatic fluid. As we spend a quarter to a third (the lucky ones) of our lives sleeping, this gives the opportunity of the fluid to gather. Lymphatic fluid relies on muscular contraction to move. Genetics and other factors certainly play a role here to though. The muscles under the eye are quite thin and other than intense squinting, the process of draining lymph is fairly passive.
You will want to be careful with the use of fillers under the eyes, if they are not placed deep in the correct plane, it could make the area worse. I would such a consultation with a medical aesthetics professional to guide our treatment process, but you could look at treatments like morpheus8, PRP, midface support with dermal fillers. There are a lot of options... so don't loose hope!!
I hope you are well!
have a great day!
Dr Dallas Walker

I'm a 34-year-old woman — I’ve had genetic dark circles my whole life, but I’ve also worn glasses my whole life so they never really bothered me…until now. I recently got LASIK, and now my under-eyes are staring me in the face (literally) and I’m wondering what the best option is. Would something like retinol work? I've read some concerning stuff about what happens to under-eye filler; yea or nay? Do blepharoplasty, fat transfer, or lasers seem like the answer? Thanks!

What's the best treatment option for my under eyes? (Photo)

Hello there and thank you for your question!
Dark circles can arise from a number of causes! When using filler under the eye its goal is not to remove dark circles caused by pigmentation, but rather to correct a volume deficiency that is lending to the creation of shadows in the eye area. Every person is different and thus volume replacement will need to be decided by the medical professional that is examining and treating you! 
Its important to note, that often you will be examined and consulted regarding your under eye deficiency and the professional looking after you may start examining your cheeks and Midface (apples of the cheeks) as lack of volume here can often be associated with the optics of the underage deficiency. I say this because under the eye tends to need very little volume, but correcting it in isolation may highlight the deficiency below it. The tear trough often needs support form below. 
There are many options to explore for pigmentation and some are as straight forward as skin care options.
I hope this helps!
Have a great day!
Dr Dallas Walker

How many ml of hyaluron do I need per eye to remove these dark circles? (Photos)

Hello There, 
Firstly, I am a massive profhilo fan! What it does for skin quality is unparalleled! I am sure you will love it too!
Profhilo is a deep dermal treatment! The Dermis is the second layer of your skin, The dermis is similar in structure to a mattress and it supports the epidermis (top layer of skin, what you see & feel from the outside) As the dermis ages the "Mattress" can become less efficient and less structured. Therefore by putting profhilo into the Dermis, the high quantity of uncrosslinked hyaluronic acid (32mg/ml) can help give support back to this layer: thus improving collagen and elastin support, and supporting the cells that make the new collagen, and a lot of hydration (giving the skin glow!) 
I say all of this as manipulating a cannula in the dermal space would be very difficult to do, painful and inefficient. profhilo is placed with a needle. And the product itself settles nicely into place on its own, it doesn't need to be spread. Its important that the profhilo is in the dermis and not deeper or shallower, otherwise you will really miss out on its benefits!
I hope that helps!! 
Have a great day!
Dr Dallas Walker

i did my profhilo treatment yesterday, i am 34 years old, the doctor made the treatment with cannula instead the 5 dots technique i google a lot and have not saw many places that mention this treatment goes with cannula, only some mentions that it can be done with a needle or a cannula i wonder what the pros and cons using a cannula in this treatment?

What are the pros and cons of using a cannula with Profhilo?

Safety is pivotal! With or without previous surgery safety is essential. This procedure is largely done with a cannula. Cannulas are blunt devices that tend to move around vessels, thus radically improving safety. It will be up the discretion, techniques and experience of your injector. But this procedure is possible post blepharoplasty. Assuming you are a good candidate for tear trough. 
Hope that helps!!
Dr Dallas

Is filler safe after lower blepharoplasty? I understand it is a bit of a blind treatment so I was wondering if it is safe after surgery when vascular anatomy might have changed

Are fillers safe in areas with previous Lower Blepharoplasty?

When we use filler under the eyes it has to be below the muscle or it can really look like it shouldn’t be there. Getting it dissolved was likely the right choice. But this doesn’t mean it cannot be done correctly in the future. 
There are other options to tighten that skin and nourish it! Using retinol and eye serums is really useful for your day to day maintenance. But also the Sue of PRP/meso therapy help with maintaining youthfulness. Then you can look at microneedling, or even better Morpheus8 (microneedling with radiofrequency). There are also laser options like CO2!
Hope that helps!

Hello doctor, Last April, I made the huge mistake of getting eye fillers. The doctor told me I had volume loss and injected the filler. I lmuch worse with the filler. I looked much worse —My face looked too big, it was swollen everyday, and my eyes looked too small and almost had a different shape. I wasn’t happy and got it dissolved after 10 months. My under-eye looks terrible now. There are dents &amp; festoons. It cannot be ageing. Please help.

Damage from filler/hyaluronidase - what can I do? (Photo)

Good afternoon Jenna, 
Neck lines have a lot of options to help you reduce them, as the skin folds in the same places over and over, they will require maintenance to keep their visibility down. Your focus needs to be on strengthening the skin in this area. Using Vitamin A (retinol/retinoids) can help, and its something you can use at home and several nights a week.
Further treatments such as micro needling, Morpheus 8 can really help. We do use dermal filler in a "strings of pearls" technique. This puts small bits of volume under the lines to lift them out. Lastly to treat the dermis (second layer of skin, the architecture of the skin) of the skin of the neck. This improves the support structures of the skin and adds an immense about of hydration to the area also!
I hope this helps! Have a great day!
Dr Dallas Walker DrDallasClinic Aesthetics

These neck lines are genetic.. no matter what weight i am at they have always been there. I had a friend get beltero but haven't found an injector to do that by me. What do you think my best option is?

What are my options for horizontal neck lines? (Photo)

Dallas Walker, MBBCh

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