How Many Syringes of Restylane for Long Tear Troughs?

I am 28 years old, and have really long tear troughs that go through my cheeks, left greater than right. Mine aren't necessarily terribly deep, but they interfere with the nice roundness my cheeks used to have and bother me terribly. Also, I feel that my nasal labial folds and corners of my mouth could be plumped up a bit, because I feel like my profile is a bunch of down-angled lines that are unflattering. Based on my photos, how many syringes would you think I would need? Thanks!

Doctor Answers 18

How much Restylane in tear troughs

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The tear trough is a small area of depression right below the eye, starting at the mediat corner of the eye.  The horizonal lines to which I believe you are refering are not tear troughs.

Restylane is an excellent treatment for dark circles under the eyes.  Only small amounts of the filler are required to improve the tear trough area.  One syringe split between the two sides should be fine. An overfilled tear trough area can look swollen and much worse than no treatment at all.

The lines that I see on your photos that run horizontally across your cheeks are probably due to central facial volume loss.  That volume loss may contribute to the accentuation of the nasolabial folds as well.

Consult with an experienced dermatologist or plastic surgeon regarding volume restoration in the midface.  That can be done with Restylane, Radiesse or Sculptra.  Restoring volume to the mid face should improve those lines and the nasolabial folds.

If you choose just to have the nasolabial folds addressed by themselves, I would start with one syringe split between the two sides again.  More can be added a couple of weeks later if the corrections is not sufficient.  That is easier than dealing with an over correction.

Short Hills Dermatologic Surgeon

Filler for Tear Trough improvement

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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.

Restylane tear troughs: go conservative, you can always add more...

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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.

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

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Syringes Recommendation

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While in person consultation would be important to verify, a 0.5 cc or 1.0 cc syringe should be sufficient for tear throughs.  1 to 2 syringes of 1.0 cc Juvederm or 1 syringe of 1.5 cc radiese should be sufficient for the lower face.  

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

How much restylane for tear troughs?

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very little is needed for that area, but consider Sculptra for the more lateral extension of the trough which is actually cheek descent. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Long Tear Troughs

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One syringe of Restylane should be sufficient to treat your tear troughs.  Deciding between a 1 ml or 0.5 ml syringe is hard to judge from the photos.  For the lower face, Radiesse 1.5 ml or 0.8 ml will likely be sufficient in a 28 yo without significant facial aging changes.  I find Radiesse in the lower face to be more long-lasting and a better value.  Hope this helps.     

Brian M. Braithwaite, MD
Chicago Plastic Surgeon

Restylane and Tear Troughs

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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.


How Many Restylane Syringes for Tear Trough Procedure?

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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.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Restylane for tear troughs

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Start conservatively with one syringe and balance both sides as  the areas are being filled rather than starting with one syringe on one side. In this way you may be able to get by with one syringe.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Tear trough correction with filler

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To corret tear troughs with filler it could be ½ cc for both sides, or if the troughs are very long then it could be ½ cc per side. So one to 1.5 syringes total on average.

Fred Weksberg, MD
Toronto 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.