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.

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).

This is a potentially dangerous area and under eye Restylane should not be done by a nurse or an aesthetician in my opinion. So, only a doctor should do this and a plastic surgeon is better than a dermatologist in this anatomically sensitive area because they see the anatomy often during surgery and they know better exactly where to put the material and can see the internal anatomy in their mind's eye.

Restylane is a great product however under eye injections are very tricky. In my opinion it would be better to consult with a facial plastic surgeon to decide first if injections would be better than a surgical or laser approach. If at that point the surgeon still recommends filler, go with whomever that surgeon recommends. Sometimes it is the doctor, a physicians assistant or a nurse. The key however is the experience and expertise of the injector and knowing whether or not it is in your best interest. Chances are that if you just go to a Medical Spa that is limited to injections, then 9 out of 10 times they will recommend injections because that is the only tool they have. When you consult with a physician office that offers may different options from surgery on down to skin care products you are most likely going to get advice based on your specific need.

In any event be very cautious. I have seen good results but more often than not, I see patients coming to me to fix what was originally done with under eye injections.

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.

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.

Under the eye is the hardest area to get good result and has risk. I would trust a board certified plastic surgeon or dermatologist who has done this before, but not a nurse injector. There is a very small risk of injecting into blood vessels and the injector should be familiar with the anatomy of the eye.