Long-term treatment for under-eye hollows? (photo)
Doctor Answers 8
Long-term treatment for under-eye hollows?
Most expert experienced artistic plastic surgeons have a variety of procedures at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers with hyaluronic acid fillers like Restylane which usually last 6 months to 1 year, micro-fat grafts of your own tissue - 30-50% lasts permanently, and blepharoplasties which are more than you would need at this age. There is no one best procedure that would be applicable for everyone. Each has benefits and potential drawbacks. The vast majority of board certified plastic surgeons with extensive experience in eyelid surgery and soft tissue fillers would warn against using a permanent synthetic filler because of the long term complications which can occur even years after injection and are difficult if not almost impossible to correct.
The best option in any particular patient needs to be individualized based on desired outcome and anatomy.
Following the advice of anyone who would presume to tell you exactly what to do based on limited 2 dimensional photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Long-term treatment for under-eye hollows?
Filler is a great option for undereye hollows. I avoid permanent fillers in this area as any problems that are created with the injections are, in fact, permanent and difficult to remedy. In theory fat transfer can be used in this area and many advocate it but I've found the longevity of the fat is unpredictable and you have the risk of lumps and bumps. Dermal fillers like Restylane do need to be repeated about once each year but the results look natural and any bumps or asymmetry can be remedied either with a small amount of additional filler or treatment with Vitrase.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon
Using regenerative skin treatment improve eyelid skin quality for the long-term, along with fillers to add immediate volume
In our practice, we are combining hyaluronic acid fillers with platelet-rich plasma. Being very active with the regenerative medicine field, I have been using platelet-rich plasma combined with extracellular matrix for hair loss and I also use it for volume correction for acne scars. For the tear trough area, I use platelet-rich plasma because it stimulates the body’s own vascular endothelial growth factors and collagen. Platelets are cells in the blood that are necessary for healing. So we draw your blood, spin it and concentrate the platelets and the plasma that is carrying it so that we can mimic the healing response to restore quality of the skin and volume. There is a more long-term permanence to this type of procedure because it has a real improvement in the skin quality.
Since you’re skin is naturally very thin and you’re only 25 years old, you don’t have as of yet, age related changes. I think that the combination of platelet-rich plasma and hyaluronic acid rather than just hyaluronic acid alone would be a good option for you. I suggest that you find a doctor that you trust and feel is not driven by a purely financial incentive. You should understand what the risks and benefits are. I hope the information about the platelet-rich plasma was helpful in your educational process. I wish you the best of luck, and thank you for your question.
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I routinely perform fat transfer to this area for patients in your position, who don't want to have routine injections with filler. The fat graft lives and is potentially permanent. I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.
Best of luck to you!
Well-performed Silikon-1000 injections may work well for permanent correction of under eye hollowing.
Based on your photos, you may be a candidate for lower eye lid filling. Our experience is strictly with Silikon-1000, an off-label filler for permanent results. The skill of your doctor is imperative when filling your delicate under eye area.
Hope this helps you.
Cost effective or not for your dermatologist, Restylane is the safest and best solution for this.
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.