Treatment for Sunken Areas Around Eyes and Nose?

Question

I have sunken eyes, especially on the inset of my nose. I have had my "tear troughs" filled with Restylane, but I still get asked if I have a black eye! I have consulted with a plastic surgeon about this and she said that if I were to get filler in that area, that I risk blocking my tear ducts. Any advice? What other treatments would you recommend?

Ron Shelton, MD · Answer

Treatment of dark circles of the lower eyelids is difficult. There is no predictability in the results for coloration. Sunken eyes often look darker and fillers in the tear trough may help. If the Restylane is placed under the muscle the cosmetic result may be better than if it is placed above the muscle because sometimes the filler can cause a bluish tint if it is seen under the thin skin. Laser resurfacing may help induce more collagen production and the dermis may become slightly thicker thereby decreasing the darker color that is seen from the underlying tissues. Some advocate the use of different creams that may help diminish the dark color. One of these creams uses vitamin K, such as Illume. A few patients see improvement and others do not. Fat transposition can be done by a surgeon to help fill the area.

Jeffrey E. Schreiber, MD, FACS · Answer

If you're tried fillers and they haven't worked out for you, implants may be a good option.  These are usually made of silicone or plastic and are placed via incisions in the lower eyelid skin.  They are permanent, so make sure it's something that you really want to do.  In the meantime, however, you may need more that the usual amount of filler to get the results that you want.  Good luck!

Kenneth D. Steinsapir, MD · Answer

Dear Black Eyes
I was just quoted in the September Harpers Bazaar regarding the use of Restylane to fill the under eye circles. I told them that there is almost no reason to do lower eyelid surgery. Even if you do have a little fullness from lower eyelid fat, the circles can be filled in until the areas are smoothed. The average patient needs more than 1 ml of Restylane under each eye. Recognize that the skin is thin here and placing filler in this area is an advanced technique.
It is not true that treating this area with filler with Restylane will affect your tearing mechanism. This is just your Plastic Surgeon's way of saying "I have no idea how to accomplish what you are asking (and I want you to do surgery anyway)." Don't make someone do something they are not comfortable doing. My advice is to look at the liquidfacelift website for a highly qualified injector in your area who does these treatments. However, please recognize that not only is this an advance technique but it also is a bit of an art form.

Tanveer Janjua, MD · Answer

You can get a filler that builds up your own collagen such as Sculptra. Make sure the dilution is correct.
The tear duct injection would happen by wrong placement of the material.
Regards.

William Portuese, MD · Answer

There are tear trough implants that are specifically made to improve and augment that area of the cheek.  They are inserted through underneath the upper lip and placed over the cheekbone to try to fill in the area of the tear troughs when fillers have failed.  They are also totally removable in case patients do not like them.

Treatment for Sunken Areas Around Eyes and Nose?

Answers (10)

Answer: Sunken Eyes around Nose

Answer: Sunken Eyes around Nose

Answer: Tear trough implants for sunken eyes

Answer: Tear trough implants for sunken eyes

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Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.

Treatment for Sunken Areas Around Eyes and Nose?

Answers (10)

Answer: Sunken Eyes around Nose

Answer: Sunken Eyes around Nose

Answer: Tear trough implants for sunken eyes

Answer: Tear trough implants for sunken eyes

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Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.