How Many Syringes of Restylane for Long Tear Troughs?

Hi @sadcheeks. I recommend starting with 1 syringe. You would be a great candidate for tear trough
fillers. Restylane and Belotero work great. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

The number of syringes of Restylane or Jeuvederm is highly dependent on the exam and appearace you wish for. For that reason we typically do a significant correction the first visit then "fine tune" afterwards.

Patients especially on their first time may require less than 1cc of Restylane for both sides, so 1/2 cc per side.  You can always add more if you need it.  I like to err on the side of less product to obtain the most natural result possible.  I would consult in person with an Oculoplastic Surgeon or a physician with extensive experience with the delicate and complex anatomy under the eyes.

Typically in younger patients that do not have deep tear troughs, 0.25 cc's per side is sufficient, for a total of 0.5cc. Some patients that are extremely deficient my require one to even two cc's. If there is product left over you can use it over the lateral cheeks to accentuate them. Under the eyes, Restylane lasts longer then in the lips and nasolabial folds, up to one to two years.

Restylane under the eyes is better than Juvederm, as it does not absorb as much water and therefore you will not look as puffy right after injection. Also, if you are not pleased with the result you can use hyaluronidase to remove the product. I have however, never had to use hyaluronidase with my injection technique.

Radiesse should be avoided in the tear trough area as any resultant nodulairty is difficult to treat in this area. Radiesse however is an excellent volumizer for the cheeks and mid face.

 

Hello sadcheeks.  Based on your pictures, we may actually recommend two different fillers for you.  The darker areas immediately under the eye, we do categorize as a tear trough issue and would most likely use a .4cc Restylane syringe to address this issue.  This would be the total estimate including both sides.

As the line move3s further away from the eye, we see what's called a "malar separation".  This means that the muscle in this area has moved downward and is creating a depression where it is pulling away from the upper cheek.  In this area, we would very likely use a 1.5 cc Syringe of Radiesse for fill and support.  This would be the total estimate including both sides.

See the pictures below for a patient that had a similar problem.