I notice every time iI see videos with under eye fillers the patient always has their eyes wide open. Is this a must?

Hi Alexis. It is not necessary to have your eyes open during filler injections in the tear trough areas. Sometimes with the eyes open, or looking upwards it will accentuate the tear trough area and help guide precise placement. Also, if a patient has really long eyelashes it can get in the way of the injections and for that reason sometimes it is needed to keep your eyes open briefly. If you are freaked out by needles then I recommend finding an injector who uses the microcannula technique. It helps make the injections much more comfortable and is associated with less risk of bruising and swelling. Hope this helps answer your question!

Most of my patients prefer to keep their eyes closed during the treatment.  I do ask them to open their eyes intermittently so I can evaluate the results as the session proceeds but the treatment usually takes no more than 15 minutes and when the needle or cannula is being used, you can keep your eyes closed.  After the first few minutes, the area is entirely numb so most patients are very comfortable and sometimes I'll ask patients to look up when we're doing the final layering of the product but this is only helpful some of the time and only if the patient is comfortable doing so.  We also give patients medicine to relax orally if they are nervous such as xanax and vicidin if needed so the experience is not a scary one.  The skin is also numbed and ice is being applied by the assistant as I inject so it's more scary to think about the procedure at home than when you're actually having it, patients will tell you.  We are also in the process of installing nitrous oxide (laughing gas, used by dentists) for patients who are very nervous during these types of procedures but usually that treatment would be for longer procedures that are more involved such as lasers, ulthera, etc.Make sure to see an injection specialist who is familiar with the eye area as this is an off label treatment and complications can occur, especially with inexperienced and non board certified providers.Best of luck!