How Does One Find an Experienced Doctor for Restylane for Sunken Eyes?

Hello.  The under eye area is one of the more difficult injection techniques to perform well, at least for those not trained.  One of the key questions to ask, regardless of the injector, is what technique are they using.

There is a very specific technique where the product is injected "under the muscle".  You should know whether your injector will use this or not.  Any tear trough procedure we have ever seen that where the patient is unhappy is invariably one where this technique was not used.  The skin under the eye is very thin and dermal fillers are not easily placed in the same manner under the eye as they are in other areas of the face.  This is the reason to inject under the muscle in this area.  

Also, ask for photos and better yet, get a referral from a friend.  Good luck.

Although this treatment has become more common, with more doctors performing it, consult someone with expertise in the anatomy of the region.  Consult an oculoplastic surgeon.

 

The restylane usa website has a physican finder which can be used to identify qualified injectors in your area. Careful consultation with 3 - 4 experienced and expert injectors will help you identify the one that best fits your needs.

I would recommend speaking with a board certified plastic surgeon who performs both blepharoplasty and injects fillers in this area. If they have experience with both procedures they can advise you as to the best course of treament. Some who only has one hamer will do the same thing all of the time. You should look for someone who can utulize all of the available surgical techniques and fillers.

 

I recommend that you have a consultation with a board certified plastic surgeon, not just because of my own training and experience, but because plastic surgeons have many techniques available in addition to filler.  I am less inclined to recommend filler if I do not think that it will satisfy the patient's needs and can discuss a whole range of treatment options.  If you see a physician who can only offer you filler, then you are more likely to be pushed in that direction as opposed to an objective assessment of your condition. Ask yourself if you are comfortable with the physician you've seen.  Did he spend enough time with you and address your concerns?  Was the staff congenial?  Did you feel that you were treated like an individual?  Who will perform the injections?  Will any analgesia be provided?  If you believe that there is a complication, does the doctor have a 24 hour answering service?  You will know what questions are most important to you--don't hesitate to ask them!

The tear trough and under eye area is a place that responds well to fillers.  Placing fillers in the tear trough and cheek area can greatly improve the appearance of the face.  Making it look younger and more rested.

One caveat is that this can be a challenging area.  It is helpful to find an injector who specializes in the under eye area.  I think it is particularly helpful to see before and after images of other patients with similar issues under the eyes.

Good luck in your search for information.

If you have friends that have had it done and have been pleased with the outcome, this is a good place to start.  Next, consult with your Dermatologist as to whether or not he or she has had experience with fillers in this area.  It is a delicate area.  Any injector who tells you that he or she has NEVER had a patient bruise or get a lump or need a touch up, has not injected enough patients and does not have enough experience!

Only select a board certified plastic surgeon who performs this procedure on a regular basis.  Ask the doctor during the consultation if he does this treatment often.  The eyelids are a delicate area, that can bruise easily.  Take arnica before and after the treatment and refrain from using aspirin products up to 10 days before the treatment.

 

Dr Tachmes

I would suggest seeing a board-certified Facial Plastic Surgeon.  They are the only surgeons who deal exclusively with the face and neck.  Often, fillers aren't the best choice for sunken eyes.  In addition, Restylane may not be the best choice.  It often will migrate after a few months and leave little bags under the eyes.  The placement of the filler is important.  Sometimes, only a subtle sub dermal injection is needed.  Often, a deeper injection is required.  Someone who has operated on the structures around the lower lid many times is best able to place the injection in the correct area.  Please use Arnica and Bromelin before the injection and avoid aspirin.  This will lead to decreased bruising.

First of all, please pardon the self-serving attitude of the plastic surgeons who recommend you only see a plastic surgeon. Regardless of their specialty, always ask about the experience of the injecting physician and make sure they have all of the "tools" to use, such as all of the various facial fillers (Sculptra, Radiesse, Perlane, Restylane, and Juvederm) that are approved for use in the United States. Always ask to see before and after pictures of patients they have personally injected. If possible, look for someone who is on the medical education faculty for one of the facial fillers. If they have been selected to train other physicians how to treat the aging face they are likely to be good, experienced injectors.