Could I benefit from another syringe of Restylane? (Photo)

I am 4 days out from having my tear troughs filled with 1 syringe of restylane. Tho some of the hollowness is gone and my cheeks seem a bit fuller, I still see tear troughs. I also feel hollow looking under my eyes and towards the outer lower edge. Would another syringe work? I hate my under eye wrinkles but as i understand it filler won't help this? What about towards the hollow outer eye area? I almost feel like my under eye wrinkles are more pronounced after the filler? I see my doc next wk.

Doctor Answers 8

Restylane in Tear Troughs

By the looks of your photos, the under-eye area looks great! Where fillers can take up to two weeks to settle and mature, I would recommend you give it the full amount of time before you start inquiring about additional product being added.  


New York Dermatologist
4.4 out of 5 stars 5 reviews

Settling of fillers do take a couple of weeks, and adding after that period is easier than reducing

I’m a board-certified cosmetic oculofacial plastic surgeon. I use Restylane, and Juvederm which are hyaluronic acid fillers. I also do PRP or platelet-rich plasma for rejuvenation of the under eye areas.

When I place the filler, I always wait about two weeks for it to settle. There’s always room to add when needed. I feel like it’s best to be conservative and I suspect your doctor probably feels similarly. It’s easier to add than it is to subtract. One of the advantages of hyaluronic acid fillers is that you can use an enzyme called hyaluronidase to dissolve the filler. However, it has been my general principle to wait for about 2 weeks and allow the filler to settle in and to blend.

There are ways to approach volume directly or indirectly. When I look at the eyes, I look at the area, take a step back, and look at the whole picture. I not only look at the eye and the tear trough area but also at the eyelid cheek junction, submalar area, or the cheek area. Sometimes, when the patient focuses on the tear trough area, they’ll often realize that when we fill the volume below that, it creates a balance and a harmony. This is an art in the way that area is sculpted.

As far as fine lines and wrinkles are concerned, in our practice we use technology such as fractional CO2 laser as well as platelet-rich plasma (PRP). PRP is derived from your own blood and it contains growth factors and healing properties that stimulate collagen formation. We often combine it when we use a hyaluronic acid filler to improve the quality of the integrity of the skin and restore volume.

I suggest that you review your photos and get a sense of how you improved and then decide with your doctor whether or not additional volume is appropriate. I always explain to patients that although the word syringe seems like a lot, for example one or two syringes, each syringe contains approximately only one milliliter which is basically a baby teaspoon. It can make a big difference by strategic placement, but in the end, it’s not a lot of volume. When things settle out, you may need additional material. I think that you’re in the right track with following up with your doctor. You can certainly explore what these other concerns are.

I always explain to my patients that the whole is greater than the sum of its parts, and when we do under eye rejuvenation, combination of modalities can often result in a better outcome such as the use of hyaluronic acid filler with PRP, or fractional CO2 laser. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Do I need more filler?

From the pictures that you have provided, you appear to have a great result. In my experience, it's better to be a touch underfilled rather than over filled. 

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Under eye fillers

Based on your pictures, you look great and it looks like the treatments worked well.
Under eye fillers needs to be injected by expert physicians and most of the time, the less is better and too much filler (it can happen very easy) can look puffy for a long time.
When it looks good - it is time to stop.

Mariusz Sapijaszko, MD, FRCPC
Edmonton Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Lower Eyelid Hollows and Wrinkles

Based on the pictures I do not believe you need additional filler in the lower eyelids.  Hyaluronic acid fillers like restylane attract and retain water and can cause some swelling and plumping of the tissues.  This can sometimes makes lower eyelids swollen or accentuate wrinkles.  Let the filler settle in for a month or two before adding any additional filler to the area.  Slight undercorrection is much better than overcorrection which can cause swelling, puffiness or bulging.  

Lower eyelid wrinkles are a separate problem which can be treated with delicate skin excision (pinch technique), a chemical peel, or topical skin tightening products (temporary).
You can address these concerns when you see your doctor.

Patrick Flaharty, MD
Bonita Springs Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Restylane under the eyes

The eye area is a very delicate area to fill.  I would wait two weeks after the injection to determine if you need more filler.  Can you post the before photo as well? Botox in combination with fillers such as Belotero and Restylane usually finish the results.  Please consult a board certified dermatologist with a great deal of experience with facial fillers for the best cosmetic results.

Could I benefit from another syringe of Restylane?

Without a before photo hard to tell the 1 syringe of Restylane effect. You might need another 1/2 syringe. As for the 'wrinkles' I recommend microBOTOX injections in a series of two sessions. 

Tear trough

It usually does not take a great deal of material for the tear trough but i do not know what you looked like before. More material will improve the appearance so ask your doctor when you go back

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

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