I read that fillers don't usually help with the deep indentions but I didn't want to go through surgery if I could avoid it. But the fillers (Restalyne Classic) aren't giving me the results I'm looking for. So I'm wanting to see what procedure(s) would need to be done to get a smooth cheek and under eye that I've wanted most of my life? I would like to avoid surgery by not as much as I don't want to feel like I look old and tired all the time. Please help!
Answer: First, the filler service you have is not helping you. Festoons, under eye hollows, and dark circles are very tricky. These services are very technical and fussy to deliver. It is not unusual for me to take more than an hour to place the kind of service you need. Most of the issue in your photographs is consistent with hyaluronic acid overfill. You did not supply us with a before picture, but the photos suggest that fillers have been inadvertently placed into the bags making them worse. All this product has to be removed. While there are surgical and chemical peel options, I see no reason why a correctly performed filler service would not profoundly improve your issues. Here is the rub. I see patients who fly in from all over the country and as far away as Europe and the Middle East. You would not fly to Beverly Hills from Dubai if you were not pretty frustrated with your local injectors and that is exactly the case. Fix the filler and get the right service. Whatever you do, do not get talked into fat graft in this location. Many of the surgeries offered for festoons do create unfixable issues.
Helpful 2 people found this helpful
Answer: First, the filler service you have is not helping you. Festoons, under eye hollows, and dark circles are very tricky. These services are very technical and fussy to deliver. It is not unusual for me to take more than an hour to place the kind of service you need. Most of the issue in your photographs is consistent with hyaluronic acid overfill. You did not supply us with a before picture, but the photos suggest that fillers have been inadvertently placed into the bags making them worse. All this product has to be removed. While there are surgical and chemical peel options, I see no reason why a correctly performed filler service would not profoundly improve your issues. Here is the rub. I see patients who fly in from all over the country and as far away as Europe and the Middle East. You would not fly to Beverly Hills from Dubai if you were not pretty frustrated with your local injectors and that is exactly the case. Fix the filler and get the right service. Whatever you do, do not get talked into fat graft in this location. Many of the surgeries offered for festoons do create unfixable issues.
Helpful 2 people found this helpful
Answer: Best treatment options for festoons Thank you for your question and photos. Festoons like yours can be challenging to treat, so make sure the doctor you are working with is board certified and has extensive experience working with this concern. When fillers are administered correctly, they can produce very good improvement under the eyes. Skin tightening treatments like Ultherapy might also give you some positive results. Find a doctor with expertise in nonsurgical skin rejuvenation for an in-person evaluation and treatment plan customized to your needs and expectations.
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Answer: Best treatment options for festoons Thank you for your question and photos. Festoons like yours can be challenging to treat, so make sure the doctor you are working with is board certified and has extensive experience working with this concern. When fillers are administered correctly, they can produce very good improvement under the eyes. Skin tightening treatments like Ultherapy might also give you some positive results. Find a doctor with expertise in nonsurgical skin rejuvenation for an in-person evaluation and treatment plan customized to your needs and expectations.
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January 23, 2020
Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer
Helpful 1 person found this helpful
January 23, 2020
Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer
Helpful 1 person found this helpful
December 22, 2019
Answer: Festoons are challenging There are two anatomic concerns here:1. Lower eyelid fat prolapse. This is sometimes addressed non-surgically with the use of fillers in the hollow (tear trough) below the fat in attempt to camouflage the fat, often with good success. However, I believe this is risk in your case because of the festoons. especially with hyaluronic acid (HA) fillers which draw in fluid, even with Restylane which is the best of the bunch. In fact, it may have already happened to you with the filler that you have had injected. In this case. I would recommend removing all your previous HA filler and perform a fat repositioning lower blepharoplasty to smooth out your eyelids/tear troughs.2. Festoons. This is the swelling at the top of the cheek with a slight depression below it (orbito-zygomatic groove). This is a much more challenging issue to correct and thus there are many different treatment modalities that try to address this problem. These include laser resurfacing, chemical peels, cautery, injections (doxycycline or tetracycline), RF microneedling, and in really severe cases, surgical resection. Seek an experienced eyelid surgeon that doesn't over promise results, especially on the festoon.
Helpful 1 person found this helpful
December 22, 2019
Answer: Festoons are challenging There are two anatomic concerns here:1. Lower eyelid fat prolapse. This is sometimes addressed non-surgically with the use of fillers in the hollow (tear trough) below the fat in attempt to camouflage the fat, often with good success. However, I believe this is risk in your case because of the festoons. especially with hyaluronic acid (HA) fillers which draw in fluid, even with Restylane which is the best of the bunch. In fact, it may have already happened to you with the filler that you have had injected. In this case. I would recommend removing all your previous HA filler and perform a fat repositioning lower blepharoplasty to smooth out your eyelids/tear troughs.2. Festoons. This is the swelling at the top of the cheek with a slight depression below it (orbito-zygomatic groove). This is a much more challenging issue to correct and thus there are many different treatment modalities that try to address this problem. These include laser resurfacing, chemical peels, cautery, injections (doxycycline or tetracycline), RF microneedling, and in really severe cases, surgical resection. Seek an experienced eyelid surgeon that doesn't over promise results, especially on the festoon.
Helpful 1 person found this helpful
December 22, 2019
Answer: Lower eyelids and malar festoons You present with a very difficult problem which, in my opinion, can be treated only with surgery. This is in particular the case with festoons. Combination of lower eyelid surgery and nano fat grafts may be considered. Consultation with a very experienced board certified plastic or occuloplastic surgeon with good reputation in eyelid surgery is recommended. Good luck.
Helpful 1 person found this helpful
December 22, 2019
Answer: Lower eyelids and malar festoons You present with a very difficult problem which, in my opinion, can be treated only with surgery. This is in particular the case with festoons. Combination of lower eyelid surgery and nano fat grafts may be considered. Consultation with a very experienced board certified plastic or occuloplastic surgeon with good reputation in eyelid surgery is recommended. Good luck.
Helpful 1 person found this helpful
