Thanks for your question and I think you have received some very good responses from the doctors who
have commented thus far. First and foremost, we recommend that you consult with a board-certified
dermatologist or plastic surgeon that are the true experts in the use of fillers and can help recommend
the best ones for the concerns that bother you. We do not recommend, as the others, that you have
Radiesse placed in the hollows under the eye. It may leave lumps and bumps if not done correctly in this
area. In the cheeks, in the nasolabial folds, and in the hands, Radiesse is a great filler. Many use Restylane
or Belotero in this area as they are the softest of the fillers and work really well here. And now, as
mentioned by Dr. Katz, we have Restylane Silk, the newest filler for fine lines and when injected correctly,
works very well in the tear troughs. Restylane Silk is a different filler and injection technique here is
crucial, and a little product goes a long way. Again, your provider will work with you to determine which,
and how much, filler you may need.
You should be assessed by a cosmetic dermatologist or plastic surgeon to see what would be the best approach to enhance your appearance. You may require filler in other areas, such as your cheeks, not just your tear troughs, to give you a natural look. Restylane may be an appropriate filler for you, but an experienced injector will give you the best advice.
It is best to get in person evaluation. The photos are submitted are not clear. Usually, that much filler is enough for the lower lid hollows, but sometime lower blepharoplasty may be a better option if there is truly excess prolapsed fat. See an oculoplastic specialist.
Thank you for your question. From your photo it does seem
you do have a bit of hollowness under the eyes and would benefit for cosmetic
fillers in this area. Restylane Silk is the latest filler that would be ideal
for placement in the tear troughs. Restylane Silk has a thinner (less dense)
consistency and has the ability to precisely fill fine lines. As far as how
much filler would be needed, it is hard to judge without an in-person consultation
typically though; it is more than a 0.5cc syringe. I recommend you schedule a
consultation with a qualified physician to map out the best treatment plan for
You really need an in person evaluation to determine if one tube is enough. Most often people need cheek filling as well as the tear trough and this will usually take more than one tube. However, go to someone who uses microcannulas as this limits the bruising and swelling and can give a more precise improvement without complications. Best, Dr. Emer.
Radiesse is made from the mineral component of bone and teeth. You can't use Radiesse close to the eye. It can leave bumps. Hyaluronic acid products like Restylane works better, as well as fat grafting (fat transfer). However, you may have orbital fat pad herniation (bags). If this is the case than adding products will only enhance the bags. You may need orbital fat pad repositioning with fat grafting. I could know more if I saw better photos or saw you in consult.
Hi Diana. We agree with Dr. Echavez that we do not like Radiesse under the eyes. Radiesse tends to be bumpy or lumpy under the eyes and especially since it looks like this is the first time you would be undergoing the procedure, you should have it done with a Hyaluronic acid based product like Restylane that can easily be adjusted with Vitrase after the injections.
In the area of how much product, it does not appear that you would be satisfied with 1.3 CC. In someone like yourself that has pronounced fat loss under the eyes, we would recommend 1 CC per eye of Restylane.
To see examples of before and after pictures for Los Angeles based patients that have had the same injections with Restylane, click the link below.
Looking at a picture is always hard to determine how much someone will need. I think at least a 1.0 cc syringe of Restylane is needed. I would do that, then re-evaluate in 3 weeks to see if you need more. Radiesse is too thick for this area and will be seen as lumpy. I prefer blunt cannulas for this area for safety and less bruising.
After reviewing your pics and your concerns I would recommend placing 1 syringe for both under eyes of Belotero. Belotero is the thinnest of the HA fillers and I think it is best suited for under eye hollows.
Personally, I would not recommend using Radiesse in the tear trough area under the eyes because it is fairly firm and lumps can develop in that area. I would recommend using Restylane in the tear troughs however. Sometimes the 0.5cc syringe is enough and sometimes the 1cc syringe is needed. It just depends on the individual. It is a bit difficult to judge how much you might need just based on the photos you provided.