Why Didn't The Filler for Under Eye Hollows Do the Job?

Filler under the eyes doesn't always work. It depends on your anatomy and the cause for the dark circles. The best candidates are people with small bags, then a dent called a tear trough then a cheek mound. Hll-valley-hill. The valley between the two hills is filler with filler such as Restylane. If you just have hollow eyes, filler may not always do the trick. You can't always treat certain shapes of facial anatomy by adding injection of a gel. Sometimes it may just be a matter of using less or doing it in stages.

           Restylane to the tear troughs is probably as good a treatment option as is available. You may need more product placed at a different depth or a different locale to balance the appearance.   You may need some of the material present dissolved prior to proceeding further.  All of this could be determined during the exam. 

Kenneth Hughes, MD Los Angeles, CA

Photos would really be necessary to provide you with the best advice. In general, there are numerous causes for dark circles under the eyes which may include the following:  pigmentation irregularities, sun exposure, visible blood vessels, stress, allergies, atopic dermatitis, pseudoherniation (outpouching) of fat from the eyelid, and heredity, to name a few.  Fat can cause the appearance of dark circles, which can be corrected by fat repositioning blepharoplasty.  As individuals age, skin tends to thin and the normal fat pads in the eyelids herniate from their normal positions and become more prominent.  This prominence can appear as bags under the eyes, and the shadow they cast appear as dark circles, while the thinner skin causes blood vessels to be more noticeable, contributing further to the dark hue.  Some pigment can be treated with laser and/or bleaching creams.  However, if it is too deep the treatment will not be effective.  In general, Restylane injections for the tear trough require an experienced professional. If you are not happy with the way the Restylane looks, it can be dissolved with the enzyme hyaluronidase. I would recommend communicating your concerns to your physician, as they will be able to help you determine the next step. Thank you, and I hope this helps.

Restylane works great in mild hollowness of lower eyelids only in the 'Tear Trough' areas. If you have large fat bulges or have hollowness more on the sides away from the nose, then the result is not as great. In those cases Blepharoplasty is the only good solution.

Regards

Dr J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Without first viewing photo's or seeing you in person, it is very difficult to answer your question. You should consider posting photo's and providing more info for better review.

Hi Toluca.  We'd be happy to give our opinion, but you would need to post photos before and after the procedure to give you a better idea.  The "pools" of product you mention does not sound right.  If your injector were to inject under the muscle, which is the most widely accepted way to inject for this procedure, you should not wind up with pools of product.  That's not to say that you wouldn't be disappointed with your results, but pools of product sounds like a superficial injection and that you should find someone that injects under the muscle.  Good luck.

It is very difficult to answer this question without photos. That being said, a lot of patients with hollowing in the under eye area also have hollowing in their upper cheeks. The goal of the Restylane injections is to create a smooth transition between the lower eyelids and cheeks. This sometimes necessitates adding filler to the cheeks as well as the lower eyelids. I am not sure whether or not this pertains to you, but it might be part of the problem. You can always seek out another opinion - other doctors may have other ideas to help you achieve your goals.

When you tell someone something ahead of time it is an explanation, when you say it after the fact, it sounds like an excuse.  It very much sounds like you were treated with an inexperienced restylane injector.  You need to find someone who can adjust your service.  These procedures can be fantastic.  Some people are truly more difficult to treat than others. Consider posting your photos.  The beauty of Restylane is that it can be adjusted after the fact.  Good luck.

Thank you for your question. Restylane is a great option to treat the tear trough area (under eye area). The cost of Restylane will vary from practice to practice and the region you live in. I recommend having a consultation with an expert injector to discuss your concerns and to determine the best treatment plan for you. Best of Luck!

Pictures before and after would have helped but the technique for injecting these products is also key to achieving a cosmetically appealing outcome and they must be injected under the muscle to minimize lumpiness bumps or discoloration.