Was Told I Don't Qualify For Restylane Below The Eyes, What Are My Options?

I have very sunken eyes which have become musch worse over time, you wouldn't recognise me from a year ago? and i get tension headaches I went to a plastic surgeoun and he said the fat under my eyes is fine and I wouldnt qualify for restylane, what are my options?? i also had upper blepharoplasty 18 months ago and i think too much fat was taken off , please see photo

Doctor Answers 11

Restylane under eyes?

based on your photo you have deep set eyes with strong brow. this combination makes your eyes appear smaller than they really are. I agree with your plastic surgeon that you are a poor candidate for fill in the infraorbital area as I fear it would make your eyes appear even deeper set as you pull the infraorbital skin out with volume. I would recommend doing a test injection with a little saline mixed with anesthetic.  This would either prove we are right or wrong. If right, no harm, it will dissipate within minutes. If wrong, you are anesthetized and ready for some fill.  good luck

Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Restylane to the tear troughs

Greetings Chris~

It appears from your picture that you are an extremely good candidate for Restylane in your tear trough area.  Perhaps the surgeon you discussed this with doesn't have much experience with Restylane for this area but we have had many patients with just such an issue do extremely well and be very pleased with the results from injections.  It is very important to find someone with a great deal of experience injecting this area.  With the proper injector, you will be amazed by the improvement that's possible. 

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 145 reviews

Restylane is a good option for hollow tear troughs.

In this poto it appears that you may have some holowness in your tear troughs.  I may be worth a conservative treatment with Restylane.  Better lighting on your photo and a side shot would help to assess whether or not you indeed have hollow tear troughs.  The best choice would be to see an expert Dermatologic Surgeon or Plastic Surgeon who understands both the surgical and injection options for treating the periorbital skin areas.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Was Told I Don't Qualify For Restylane Below The Eyes, What Are My Options?

Sounds like you need additional opinions from boarded doctors in Ireland. From your so kindly posted photo I would consider a filler therapy. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Lower eyelid volume loss

To address your question about the upper eyelids-- they seem to be appropriate based on your photo.  If your eyes are able to close fully then the upper lid blepharoplasty was done seemingly well.  Your brow position seems kind of high which makes me wonder whether brow lift was also performed in conjunction with the upper blepharoplasty or this is your natural brow position.

Lower lid:  seems to be widened due to the midfacial volume deficiency/ loss. Your are definitely a candidate for filler augmentation to the lower eyelid-midface area.  Another option to improve the increase width of the lower eyelid and loss of infraorbital (under eyelid) volume is a midface lift, which can be done via various approaches. In reality, a combination of the two would probably provide you with the best result possible.  My advise-- start with the filler first and consider midface lift if the result is suboptimal.

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Lower lid augmentation with Restylane or Fat Injections

The photo you sent does show deeply set eyes, but in some cases like yours I have used about 1 syringe of Restylane per lower lid. Some physicians do not have experience with using large volumes of filler in the lower lids, and is probably why your surgeon was reluctant to do so.

An alternative would be fat augmentation. Fat is harvested from your abdomen, or thighs and micro-injected to your lower lids and midface. You may want to seek opinions from other surgeons in your area who have more experience with this procedure.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Restylane for sunken upper cheeks

Evaluating pictures for a problem such as your can sometimes be tricky because of the shadow effect that can sometimes be produced by the lighting.  That being said it would appear to me that in fact you might benefit from a filler to the area upper cheeks/below the eyes.  I have seen a syringe of Restlane produce dramatic effects in this area.  If this problem really bothers you, it wouldn't hurt to get a second opinion.

Ted Brezel, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Filler under eyes and cheeks would help

IMHO, fillers to the lower eyelid hollows and to shape the cheeks and mandibular angles would all improve your appearance.  Find a qualified MD, near you, to perform these fillers.  I like Juvederm for under the yes, Radiesse or Perlane for cheeks and mandible. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

First, stop getting surgery.

Second, find a new cosmetic surgeon.

You definitely would benefit from under eye fillers.  This is far more preferable than more eyelid surgeon.  If your surgeon only knows how to operate and does not like fillers, please expect them to encourage you to have more surgery rather than having a filler service.  That does not make their assessment correct.  As I tell people, if your surgeon tells you they are not comfortable doing something, please do not make them do it.  You need to go out and find a different practitioner who is comfortable with fillers and seek their opinion.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Filler under the eyes

Based on what you have posted, it appears that you may be able to have some fillers including Restylane or Juvederm. I would advise you to proceed gradually. I would avoid thicker fillers and would stick with hyaluronic acids.

Other treatments would include fat injections to replace the fat that was removed. One caveat that I would have would be to make sure that the person injecting the fat has a lot of experience. Fat tends to be less predictable than other molecules simply because the material is not standardized.

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

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.