Future advancements in undereye voluminization? Is regenerative med hype or substantiated?

Question

I'm curious about correcting undereye hollowing, where the contours of the orbital rim become visible. To my knowledge, the primary options are hyaluronic acid filler, fat grafting, and surgical approaches such as lower blepharoplasty with fat repositioning. I was curious whether you see any emerging treatments or technologies that show promise in this area. Additionally, do regenerative therapies such as PRP, PDGF, exosomes, or other biologics have sufficient evidence supporting tear trough voluminization, or is much of the enthusiasm currently ahead of the evidence? Or is it reasonable application based on therapeutic mechanism?

Nelson Lee Novick, MD · Answer

The short answer to your question about emerging technologies is that, at least for the present, their use remains far more backed by social media buzz than any hard science. So, kudos to you that you questioned whether the current enthusiasm outpaces the hard science. 
As to fat grafting, besides being expensive and requiring a two-step somewhat invasive procedure (harvesting the fat from location and transplanting it to the under eyes with large bore cannulas), there are other issues to consider.. While it is enticing to think that because your own fat is being auto transplanted that it will be a one-and-done procedure. Unfortunately, the fact is that much of the transplanted fat when separated from its original blood supply may actually not survive, What's more the fat that does manage to survive retains the characteristics of the location from which it is taken--meaning that if it is taken from belly, for example, when, with aging, the belly fat takes on the "midriff bulge," so, too, can the belly fat transplanted under the eyes. Not a happy scenario.
Surgery of course, besides being expensive, carries with it post-operative downtime and the risks of scarring. Additionally, surgery may also not be a one and done solution, since surrounding age-related changes in the skin, fat, and connective can turn a once satisfactory result into an unsatisfactory one with the passage of time.
Appropriately selected and properly injected hyaluronic acid fillers, on the other hand,  can work well for immediately improving under-eye hollows and tear troughs and can also be relatively easily dissolved should the need arise. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector expert to investigate this further and best of luck.

Future advancements in undereye voluminization? Is regenerative med hype or substantiated?

Answers (1)

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