I wanted to have Juvederm injected under my eyes since they are very big and starting to look bad. The doctor told me I did not have full orbits, only half, and it could not be done. I have never heard this before, has anyone experienced this? Could it be because I am of Native American descent? What are my other options now, if it's really not possible to have Juvederm?
Can Juvederm Get Injected Undereye in Half Orbits?
Doctor Answers 9
I don't know what a half orbit means
As we age, often a hollowing in the lower lid - cheek junction begins to show and is called a tear trough. This can create dark circles and is easily treated by an experienced doctor with Restylane injections. These can last for a year or longer and are more predictable than fat injections which might not take at all or might become firm and lumpy requiring surgery to remove them. Just make sure it is a real doctor (preferrably a Board Certifid Plastic Surgeon) doing your injections and NOT an aesthetician or nurse!
Always be cautious about peri-orbital injections.
The description of a half orbit is not a recognized medical term - in fact, it is unclear what you are talking about. However, you should be very cautious before letting anyone injection anything around your orbit. Please make sure that you see a qualified person before having any injections. Also, injections are not always the answer. Talk with your doctor about your specific concerns and hopefully he or she will be able to find a nice solution for you.
David Shafer, MD
Shafer Plastic Surgery
New York City
We all have full orbits
I'm not sure what a half orbit is. We all have a circular bone around the globe (eyeball). When hollowness starts to occur, and the eyes start to look "tired", often in the 30's, patients come in seeking solutions. I see no reason why most patients could not receive Juvederm to the eye cheek region if they have signs of hollowness. It may be your doctor did not think that the Juvederm was the most aesthetic solution for your problem based on your anatomy.
The aging of the lower eyes usually has several parts to it. As fat in the face wastes away with time, bony prominences become more visible. A gaunt appearance can occur. In our practice, we usually start with a softer filler than Juvederm (Prevelle), to see if patients have a swelling reaction, and then proceed to Juvederm. We prefer LiveFill for this purpose. In many practices, fat injection is performed.
Fat below the eyes tends to bulge in many patients against a membrane called orbital septum, causing a bulge. This is often treated by reduction or redistribution of the fat. The orbital septum is a dangerous layer because if it develops scar tissue it pulls down, changing the eye shape.
The cheek droops, probably as a result of loss of volume and a "deflation" effect. In our practice, we often treat this with elevation of the cheek ( with a cheeklift such as the LUSIC) plus a graft to the eye-cheek junction and tear trough (nontraumatized fascial fat, LiveFill).
The lower eyelid canthus (supporting structure) weakens over time, causing the eye to sag and round in shape.
Extra skin develops as elastic fibers are damaged by the sun. This is often treated by tightening of the skin, in our practice with a cheeklift (LUSIC).
That's our thinking at the moment, although this year a nice study from Bradley and coworkers at UCLA seemed to indicate that maybe volume around the eye is actually increasing... maybe our paradign needs more analysis... just when you think you have things figured out...
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Juvederm injection under the eye
Juvederm is an excellent hyaluronic acid based injectable that can be used effectively for facial contouring.
Juvederm is commonly used around the lips, the smile lines, the marionette lines, under deep wrinkles, under deep scars, and even under the area of the eye.
Out of all the areas that can be treated, the area under the eye is the trickiest because the skin here is the thinnest in the body and there is a very high concentration of blood vessels. At this stage in your healing you have not achieved your final result. Your best bet is to place a cold compress onto this area and wait for the swelling to resolve so that you may see your Juvederm result.
Juvederm for under eyes
We're not sure what your physician meant by the "half orbit" but we can tell you that the vast majority of our patients with dark circles under their eyes are good candidates for the "tear trough" injection procedure. We prefer Restylane in this area.
This is one of the most difficult of injection techniques and there are many users on realself that complain of bruising and puffiness under the eyes after this procedure so choose your practitioner carefully based on their experience (and before and after photos). Good luck.
I don;t know what a half orbit means? If you need filler in the tear trough area which is by your nose under your eye, then you probaly don;t need too much. This can help improve the flattening that some patients develop in this area.
Half an orbit is better than none?
It is not entirely clear what the doctor was referring to when you were told this. He was most likely trying to describe your orbital and aging characteristics with lay terminology. Juvederm and other hyaluronic acid products can be placed very effectively in the lower eyelids. See a board certified plastic surgeon that is experienced in treating this part of the facial anatomy for a full discussion on how to rejuvenate your eyes. Good luck!
Half orbit was the first manned space Flight
The first orbit of a manned space flight was not completely aroundthe earth. Aside from that, any of the synthetic fillers are not ideal for around the eyes. fat is best.
As the others physicians have said, "half-orbit" is not something we have heard of. Injections of fillers (hyaluronic acid, like Juvederm) CAN be done below the eye to help with a "tear-trough." Some patients have too much excess skin and fat in this area and are better served by an eyelid surgical procedure (blepharoplasty or "eyelid lift").
Seek out a qualified plastic surgeon and get a new consultation in person. Then, you will be able to get a more realistic answer to your problem. Good luck.
Sirish Maddali, MD
Plastic & Reconstructive Surgery
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.