Syringe or Cannula? Which is Better for Injecting Restylane in Tear Trough? (photos)

In general, a blunt cannula is the better option for this area of the face. Using a blunt cannula will give the following advantages:1) Reduced risk of bruising2) Increased safety for the patientRestylane is a great filler for the tear trough, and will yield a great result when the injections are performed properly by a specialist. I would recommend seeking the advice of the following board certified physicians when having treatment with Restylane:1) Dermatologist2) Facial plastic surgeon3) Plastic surgeonI hope this information helps, and I wish you the best of luck. 

Hi @TrueBlueGirl! Needle vs. Cannula is practitioner dependent. I prefer using a cannula since there are less risks for vascular occlusion and bruising. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

I have been injecting tear troughs for over twenty years, dating from the early days using the original Zyderm collagen filler. I have great experience in using both cannulas and needles for treating this delicate region and have found that properly chosen needles can yield excellent results with a side effect profile--i.e. likelihood of swelling and bruising--that is in no way significantly inferior to that achieved with cannulas. I prefer to use Belotero Balance, rather than other fillers, including diluted Restylane (which is often chosen for under the eyes), since this product does not result in the unwanted, bluish Tyndall Effect that can be seen when other fillers are injected too superficially or within the delicate skin under the eyes. I also use only one entrance site per side, just as with cannulas, that is numbed beforehand (making the whole treatment painless) and can reach all areas using a 1.5 inch needle. And since the needle is more rigid than a microcannula, the material placement can be better controlled--meaning a better outcome. It is especially important to seek out a board certified aesthetic core physician with extensive experience and expertise in treating this more demanding location.

While both a needle and a cannula can be used to inject the tear trough, I prefer the cannula.  In my mind, using an instrument that is blunt has clear advantages to a sharp needle.   They include:1)  Decreased risk of bruising2)  Improved safety3)  Less needle sticks in a sensitive area of the faceAs long as the product is place deep, I have never seen the bluish color from injection with Restylane.  Currently, I only use Restylane in the area and I get the best and longest lasting results in this area with that product.I hope this helps.

I much prefer cannula for my injections.  I found that using cannula reduces the incidence of bruising and it makes injection more comfortable for the patient.  However, I would not recommend choosing a doctor based on whether they prefer cannula or needle.  Find a doctor you trust and let them use their preferred method of injection.Best of Luck!

CAUSES OF DARK CIRCLESDark circles under the eyes are caused by:  Each component must be addressed.1.  Thinning out of the skin.  The underlying muscle becomes more visible creating a darker skin color.2.  Loss of volume in the tear trough due to fat loss and bony loss.3.  Excess fat and puffiness in the lower lids casts dark shadows accentuating the darkness under the eyes.Combination therapy.TREAMENT OF DARK CIRCLES1.  Treating thinning of the skin.  My preferred approach is injecting a very thin layer of Restylane.  Using a micro cannula allows this to be done without any bruising.  Because this is a very thin layer, the "tindel effect" is prevented.  Skin can further be thickened with laser treatments and topical therapies such as Vitamin C and Retinols. 2.  Loss of volume in the tear trough.  I find that injecting Restylane, and now even Juvederm Voluma, using a regular needle directly on the bony rim where there is volume loss is performed.  It is important to inject on the bone and this is more difficult with the micro cannula.  There is little risk of bleeding with these deeper injections so there is no benefit to using the micro cannula.3.  Excess volume; this is treated with a lower eye lift, blepharoplasty.  I prefer to use a stitch less approach behind the eye lid to remove the fat and tighten the skin with a Fraxel Repair (CO2) laser. In summary, one has to address each individual cause.  In your case its more the thin out of the skin than volume loss or volume excess so I would use the micro cannula.Good luck,Ran Y. Rubinstein, MD
200 Stony Brook Court, Newburgh, New York
Board Certified Facial Plastic Surgeon
Clinical Professor New York Presbyterian Hospital
National Education Faculty (physician trainer) for:
Allergan (Juvederm, Voluma), Valient (Scultpra,
Restylane), Cynosure (Cellulaze, Precision Laser Lift)
& Solta (Fraxel, Thermage)

Cannula vs Needle is an area of debate. Those who advocate a cannula will say that there is less chance of injection into a blood vessel and it may be less traumatic, so less bruising. Those who prefer a needle will say that there is more control with a needle and that the risk of injecting into a blood vessel is very low and more theoretical. I personally prefer a needle. The bigger issue is that tear trough injections are very specialized and you should make sure your board certified plastic surgeon or dermatologist is experienced with this particular area of the body.

Both Syringe and Cannula are excellent methods to inject Restylane in the tear trough. This is an off-label injection. I generally prefer a needle to a Cannula. They both actually use syringes, but it's a matter of whether or not you use a needle. The Cannula can be considered by some physicians to be less traumatic, but I feel it really is a question of the injection technique. You can equally inject with a needle. I feel that a needle produces more collagen stimulation, and you can get into different planes more easily. The important thing is which one the doctor is more comfortable with and is more experienced using - particularly in the eye area. That said, both a very small needle and a very small cannula can be used.

I prefer using a microcannula when
injecting filler, especially under the eyes since this is such a delicate
area.  A needle is used to create an
insertion point and then the microcannula is used to inject the filler.  This allows for careful and precise injection
of the filler.  Using a microcannula
reduces the chance of bruising and makes for a more comfortable
experience.  I suggest finding a doctor
who has experience using microcannulas and has great before and after
results.  I hope this helps!

Injection technique with a cannula will dramatically reduce
swelling and bruising in this area than the traditional syringe needle
injection technique.