Hi Delilah. We typically use between 1-2 CC's for this procedure so .4 is a very small amount. What you were seeing was probably swelling. Was the treatment done with a technique called "under the muscle"? If not, I would be concerned about getting more injected as this is a very technique dependent area. If your injector is placing the product deep in the skin under the muscle, then by all means go back for more. If you only get .4 CC's you may not see value past a few months. We inject 1-2 CC's to get patients 6-12 months duration. Good luck.
We don't have the advantage of pictures, but it is always good to start with less filler and add more. This makes it less likely that you would bruise or have puffiness under the eyes. So if you to,erated it well it is probably time to have a little more.
Medicis used to produce Restylane in 0.4 cc syringes (as well as 1 cc syringes) but now provides 0.5 cc, 1cc, and 2 cc syringes.
I usually find that most patients need .5ml of Restylane (minimum) for under the eye area on each side for proper correction. However, a 1/2 size syringe (which is .5ml not .4ml) of Restylane could possibly be enough for you. Or not since you think you need more. As you saw, once the initial swelling went away, you thought you needed more product added. So you might have been the more standard of .5ml per side. But each patient and each case is individual. Fortunately with HA products like Restylane you can easily add another syringe, or if you were overfilled, you can remove some. Return to your injector for an assessment and most likely, a second half-size syringe.
"This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."
it's always a good idea to do less especially if your first starting out with these types of treatment. If you feel like it is not quite enough then you can always add more. There is no cookbook or guide for this sort of thing. This should be tailored and customized to each patient.
I agree with that approach. It's always best to start with a small amount of Restylane under the eyes. Often, the 0.5cc vial (the smallest vial) is enough under the eyes. But everyone's different. I usually start with 0.5cc in the tear troughs, and see the patient back in 2 weeks to decide if that's enough. It's very likely that you just need a little more, so I do think it's best to go back and discuss that option with your doctor. Best, Dr McNeill
Without pictures, it is difficult to assess, but it does sound like you may just need more product. I would recommend returning to your doctor and considering more. This is one of the nice things about hyaluronic acid fillers in general - you can layer product on without having to overdo it.
possible that you had swelling under your eyes and that is why you thought it
looked great for the “first few days” but .2cc is a very small and does not
give very much improvement.
In my office
I typically start off by injecting 1 cc of Restylane .5 and .5 into each tear
trough. 2 weeks later I have my patient come back in for a follow up and we
decide if they want or need additional filler at that time.
It is best
to consult with a Board Certified Dermatologist with plenty of experience
injecting under eye hollows.
It sounds like you were under-dosed and it was mostly swelling that you saw the first few weeks, I do suggest you have another syringe to see full result
Restylane for tear troughs is a wonderful tool. It sounds like you just need a little bit more Restylane injected into the area for a full result. I would suggest you return to your treating physician to correct the tear trough area.
0.4 cc of Restylane is a very small amount and insufficient to treat both tear troughs. You probably demonstrated improvement based on post-procedure swelling. I think that you will find that a full cc would be necessary to establish a sufficient and longer lasting improvement. I am personally not a fan of the smaller syringes as they are less cost effective than the 1 cc dose. Many physicians offer them as a "come on" because the price seems so much lower or use them for touchups. Remember that whatever product is not used can be stored for your personal use at a later date.