What is the best and safest injection technique for tear troughs? (photo)

Hello, each of the techniques are good but I would prefer needle with volbella under the muscles. under the muscle injection are safer and give very good result.

Hello, Nurse Lindsay here! I'm a Certified Aesthetic Nurse Specialist, and Lead Nurse Injector for Board Certified Plastic Surgeon, Dr. Mark Mason. As you probably already know, all of these fillers are hyaluronic acid, so at least we're talking about the same substance. As far as technique goes, I find most injectors stick with their comfort zone. Most of us have our "favorite" products that we just have more experience with. The injector is usually a more important decision than the product itself. As far as needle vs cannula, I use both, and sometimes even use both on the same patient. I like cannula because there is usually less bruising, but sometimes a patient could benefit from the needle because it is slightly more precise with placement. I prefer classic Restylane in this area, and would say a combination of cannula and needle. When I use needle, I go to the periosteum, and cannula is generally right above, laying on the bone. The best recipe for success is an injector with a before + after gallery you're impressed with, ice, and abstaining from blood thinners at least 2 days prior to your appointment. Go with the injector you trust. You'll be happy. :) Hope this helps!

Hi and thank you for your question! Filler injection in tear troughs and under eyes is one of my primary specialties and I perform this procedure several times a day. For the area under eyes and tear troughs, cannula is the best and safest method of injection. Volbella, Belotero and Restylane are all good options for that area, although my own favorite and recommendation is Volbella for under eyes. Going too superficially runs the risk of causing the Tyndall effect (bluish discoloration) and should be avoided. In general, I perform my injections using cannula at various depths/planes, using a technique I developed that is called 4D Under Eye Lift. For best results, it is of utmost importance that you work with an injector who is highly experienced and can show you several before and after pictures of the patients treated. I hope it helps and good luck!

fillers can be injeted under the eyes in various ways and different doctors like different things (techniques and products). eye rolling shoudl be used daily (see link to emeragecosmetics.com).There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.

Thank you for your question and I understand your confusion! I can tell you I perform my tear trough treatments with a cannula in most cases, as this typically leads to a smoother result with less post-treatment bruising. As far as the filler used, I would be more concerned with the experience and expertise of the doctor performing the procedure than the product used. I advise you to work with a board-certified facial plastic surgeon with extensive experience and training in tear trough filler to ensure an optimal outcome. 

Thank you for sharing your question.  In most cases the safest treatment is deep placement of filler with a cannula technique.  Optimizing outcome will depend on the filler selected which varies based on the patient's goals and starting point.  Hope this helps.

The administration of fillers is a highly technical procedure. There are so many factors to consider to determine if you are a good candidate for it, best filler to use, the right amount, injection technique, etc. Please contact a qualified provider or a board-certified physician with extensive experience in these procedures.

Thanks for your question. I would choose the physician with the best track record and safest technique. Each provider will probably treat you the way they were trained. I personally never inject tear troughs as I have seen many complications, and the risk outweighs the benefit to me. I inject pretty much everywhere else on the face after years of training, continuing education with fellow dermatologists and plastic surgeons, and experience, but the tear troughs are one place a lot of patients regret having injected. Please see an expert, and best of luck.

Hello and thank you for your question. From your question we can advise here but nothing would compare to a face to face consultation in clinic for an accurate plan of what would work best. There are many ways to treat the tear trough safety- with current understanding most people approach this deep under the muscle with a cannula and placing product in the deep fat -predominantly the SOOF. Hope this helps, Best wishes

This is a very difficult area to treat and one with many injectors using outmoded methods. When used properly, canulas are generally safer, but not so much that it makes up for poor technique. The correct filler and placement are also very important. Unfortunately, I would advise you to avoid all three of the people you saw. None of the listed fillers is appropriate for the area as they are all too "soft." This area needs a filler like Juvederm Voluma or Radiesse. Only very rarely should filler ever be placed superficial in this area. Placing it below the fat pad, if placed on the bone is reasonable, but above the fat pad or under the muscle is not. Start over with an expert who is up on modern technique and uses the proper filler.