Who Should Give Restylane Injections? Plastic Surgeon vs. Nurse vs. Derm

There are many people performing injections with varied qualifications and skills. When considering any medical procedure you should always seek the most experienced practitioner.

When considering fillers around the eyes you should limit  yourself to the core specialties that have surgical experience in that area. That would include Plastic Surgeons, Facial Plastic Surgeons, and Ophthalmologist.

Even though the physician maybe one of these specialties, injection techniques and skill levels vary. Seek referral from other medical practitioners so you can obtain the optimal result.

Injecting is a skill. Some people paint by numbers, but there are few Michelangelo's. So beware, the best deal is not always the best result.

You will want to go to an experienced injector, whether it is a derm, a plastic, or a nurse.  

Injections for under-eye hollows is an advanced technique, so an experienced board-certified dermatologist or plastic surgeon will be able to handle the job.  That said, there are very experienced nurse injectors who may be able to do a very good job for you.  

Hi Chikiki,

Whoa, hold on Chikiki!

Great question, you had better be waiting for our answers before you have anything injected!

The lower eye lid is a most delicate and unforgiving area. Injecting the face is a medical procedure.

You should only have a very well trained, Board Certified physician in one of the core cosmetic specialities (Opthalmo-plastic surgery, Facial plastic surgery, General plastic surgery, ENT, or cosmetic dermatology) perform your injections. Even then, you are not guaranteed great results without long term complications. You want to choose a physician who is skilled, experienced, and has a sense of asthetic beauty. You must do your research and choose your injecting physician most carefully.

There are many fine physicians in lovely Montreal, so do a little more homework on your study breaks from university.

When the treatment is performed well, the results are great. For the past many years, we have been perfoming substantially fewer surgical lower lid blepharoplasties due to the successful natural appearance of lower eye lid Restylane injections.

Good luck and be well.

Dr. P

I would recommend you see a board certified plastic surgeon or dermatologist. When you contact the office for an appointment, make sure the doctor does inject this area. Not all injectors do. It is beneficial to have a physician treat you who is very experienced in filling this area below the eyes. The plane of injection, the product chosen and the knowledge of anatomy is important. Good luck.

I am not sure what the regulations are in Quebec, but in the states any doctor or a nurse under a doctor's supervision can do it, though this varies from state to state. The under-eye area is somewhat of an advanced technique so you do want to be sure that whoever does it is experienced. Whether a plastic surgeon or dermatologist, they should have aesthetic procedures as a primary part of their practice. don't be afraid to ask about this before you see them in consultation.

I agree with Dr. Aldea that you need an experienced injector. While all of the types of doctors he mentioned may have experience in this realm, Ocular Plastic and Reconstructive Surgeons study and work on this area more than most any other type of physician. ASOPRS.org will lead you to this exclusive group. Discuss with any doctor their personal experience injecting this very delicate area. I have been successfully using fillers in the tear trough for years and my patients have been very satisfied with the results.

Hi Chikiki,

Core specialties include general plastic surgeons (aka board certified general plastic surgeons) facial plastic surgeons, dermatologists, and fellowship trained eye plastic surgeons. However, this is not enough to ensure a good treatment for what you need which under eye filling. No question, this is the most difficult and demanding type of under eye treatment. You need at least 1.5 ml of Restylane under each eye. Most core specialitists are not going to be comfortable with this type of treatment.

Consider looking on the liquidfacelift.com website for a highly qualified injector and then carefully study their under eye results on their website before having treatment. The treatment is fantastic but it can also cause lumps and bumps and your injector needs to be prepared to manage these after treatment with the use of the enzyme hyaluronidase. Adjustment is necessary because every one settles differently after treatment. Think of the enzyme as an eraser that is used to refine the treatment.

Especially for the tear trough area, you should be treated by a board certified dermatologist or a plastic, facial plastic or oculoplastic surgeon who has experience using Restylane in this area.

Chikiki55:

It is wise that you are doing research to find the most experienced person to provide HA filler (Restylane, Juvederm) injections in your under-eye area. Recent advances in this technique have provided an alternative to lower eyelid blepharoplasty surgery for many patients.

Unfortunately, RealSelf and my colleagues here cannot know who is the most qualified source in your area. After doing your on-line and telephone inquiries, you may have to schedule several consultations to get the information you need.

It is easy for physicians such as myself (a plastic surgeon) who regularly perform this technique to advise using someone in our own specialty, but you should at least expect that your injections will be done by a "core physician", one whose core training and experience included the face. That includes plastic surgeons, ENT's, and ophthalmologists with oculoplastic fellowships. Many dermatologists are also experienced. A few surgeons have well-qualified experienced advance practice nurses (nurse practitioners).

I would not recommend a MedSpa, primary care physician, OB/GYN, or so called "cosmetic medicine" or "cosmetic surgery" doctor (no recognized board certification).

As my colleagues have already answered, you safest bet for quality care is going to be with a board certified dermatologist or plastic surgeon who received training in aesthetic medicine as part of their residency for their specialty. I hope you find my answer helpful.