Looking for NYC Doctor - Restylane in Tear Trough Line Caused By Thermage

I had Thermage under my eye last year at a spa and had bad results. I now have a line in my tear trough area. I would like to get this corrected and was considering Restylane but heard there may be some side-effects (I've had Restylane in my laugh lines and love it). My question is two-fold: 1. If I had side-effects could they be reversed with hyaluronidase 2. Are there any MDs in NYC experienced in this procedure who would be willing to see me for a consultation? Thank you!

Doctor Answers 12

Restylane for tear trough filler

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Restylane is an excellent filler for the tear trough and yes, if we find the result to be slighlty more than desired, the filler can be dissolved by injecting hyaluronidase.  An important aspect in your case to consider, may be that the crease you have is different than that of a normal tear trough.  If the Thermage caused this crease, which would be extraordinarily rare, then possibly the crease will not respond in the same manner from Restylane filling.  This will have to be evaluated carefully by an expert.  If the crease is very superficial, then there is a greater chance of superficial lumps from the Restylane and even bluish coloration.  Normally I inject tear troughs deep to the muscle to give a more even result with much less a chance of creating visible lumps.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Restylane for Tear Troughs

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I am sorry to hear that you had a bad reaction from Thermage at a spa.  I always encourage patients to see a board certified dermatologist to have the best results.  Restylane is a very good treatment for the tear trough area.  Any hyaluronidase injection like Restylane or Juvederm can be reversed with Vitrase. If for some reason you are unhappy with the procedure it can be reversed.  Please let me know how your experience is.

Restylane in Tear Trough to Correct Line

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Restylane is my filler of choice for tear trough/periorbital area.  It sounds like you have decreased volume in the area after Thermage.  Side effects such as lumps can be reversed with careful use of hyaluronidase.  Fat, Radiesse, Sculptra and silicone cannot be reversed so I would stay away from those.  Oculoplastic Surgeons specialize in the area around the eyes and know the nuances of the anatomy there, so consider consulting with one.  Or find a dermatologist, facial plastic or plastic surgeon who has experience injecting in that area.

Debra M. Kroll, MD
New York Oculoplastic Surgeon
5.0 out of 5 stars 9 reviews

Looking for NYC Doctor for Restylane

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Check the physician locators on the restylane usa and ASPS websites for qualified physicians. Dr. Sydney Coleman and Dr. Gerald Ginsberg are two possibilities. 

Restylane can be reversed using hyaluronidase.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Restylane - Tear Trough Area, Complications, Reversability, Hyaluronidase

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Hi Bigmistake in NY,NY,

The good news about fillers such as Restylane (which, like Perlane and Juvederm, consists of hyaluronic acid) is that most of the adverse effects related to them can be reversed with an injection of hyaluronidase, which essentially dissolves the filler material.  So if there is a lump somewhere after an injection, it can be flattened out or "erased" with the hyaluronidase.

[It is important to note that once the hyaluronidase is injected you may not be able to control "exactly" where it goes; in other words, in making a lump go down in one spot you may dissolve a little more of it than what you ideally would have wanted.  It's simply not that precise and specific.]

Many doctors - both plastic surgeons and dermatologists - perform filler injections to the tear troughs.  It's a relative straight-forward procedure from the standpoint of the injections; however, because the skin in that region is so thin, any irregularities may be unusually visible).

And whether this or any other filler can completely "erase" or mitigate an appearance you have - regardless of its source - is something you'll have to talk to your PS about in person.

I hope that this helps, and good luck,

Dr. E

Restylane in tear trough

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Restylane can be very effective in correcting the "tear trough deformity".  The tear trough deformity is a line or depression that develops with aging from herniation of orbital fat above and loss of fat along the orbital rim.   Juvederm can also be used very safely.  The reason these fillers are so safe is that they can be fully reversed with the simple injection of hyaluronidase if there are any undesirable effects from the injection like a lump or bump, swelling, or blue discoloration("tindle effect").  I rarely experience these problems in my injection practice due to technique and the amount of people I inject with these fillers around the eyes. 

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.9 out of 5 stars 120 reviews

Restylane in tear troughs

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Rstylane injections into the tear troughs is very commonly performed. I do it all the time. But if you have a line that developed from the filler, you may want hyaluronidase to be inejcted to dissolve it.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Restylane Injections for facial contouring, #restylane, #injections, #aging, #beauty

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Dear Bigmistake

Thank you for your qestion and the information about your experience with Thermage at a spa.  The cotouring of the hollows under the eyes can be done very nicely with Restylane.  My wife - Dr. Lisa Airan and I published a paper in 'Plastic and Reconstructive Surgery' in 2005 and were featured by Sarah Brown in the October issue of  Vogue Magazine for this procedure.  Removing the Restylane with an enzyme is possible if there is an irregularity in shape- but this is very uncommon. The results can last 1 to 2 years.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Restylane for under eye hollow

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I am sorry to hear about your problems after Thermage. Unfortunately, your complaint is not unusual. Restylane works well in the under eye area - as long as your doctor is experienced with this advanced technique.  As an injector trainer for the company that makes Restylane, I always caution the doctors that I am training to avoid attempting this highly advanced technique until they are really comfortable. Yes, problems can be corrected with hyaluronidase, but it is best to avoid the problem altogether even if there is a fix.  I agree with Dr. Singer, that bruising and swelling is common after these injections and you should make sure you have no big plans or events for at least a few days after your injections. 

Side effects of Restylane in tear troughs

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The most common side effects of Restylane injections are bruising and temporary swelling. The amounts of Restylane necessary to fill the tear trough are small, and are usually injected deeply to lift the tissue.

It would be helpful to see a photo to give you a better evaluation.

And to answer your question, Restylane, which is a hyaluronic acid filler, can be dissolved with hyaluronidase if the end result is not what was desired.

Emily Altman, MD
Short Hills Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.