How long will it take to see final results after tear trough fillers?

I have been injecting tear troughs and dark circles with fillers for over three decades since the use of the original Zyderm I collagen product for this purpose. In general, the results of treatment are immediate and typically evoke an immediate "Wow!" response when the patient looks in the mirror after treatment. I am not a big fan of using ordinary Restylane under the eyes, as its use has been known to give rise to the unwanted, bluish Tyndall Effect especially if the material has been injected too superficially within the delicate under eye tissues. This could possibly be the bluish color you are describing. In my Upper East Side Manhattan office, I prefer to use Belotero Balance, which possesses little to no tendency to cause this problem. (In my Israel satelite facility, where a far greater number of regulatory agency approved fillers are available, I opt for Teosyal Redensity II for this region). When dark circles are prominent, I also often add a tiny amount of a whitish-colored filler, Radiesse, which helps to lighten the region. If your current bluish coloration is indeed the Tyndall Effect, the use of hyaluronidase to dissolve the Restylane may be used.I would suggest returning to your treating physician with your concerns, and if you are still unsatisfied, a second opinion might be in order by a board certified aesthetic physician with expertise and experience in treating this area. Be sure to ask to see his/her before and after photos before proceeding.

I find that fillers and lasers are needed for improvement along with long term skin care and microneedling.  This is a genetic condition that is improved with cosmetic treatments but not fully cured.  Best, Dr. Emer.

Correction of tear trough deformity with HA fillers should be almost immediate and certainly at one week you have your final result from the injection; however, dark circles that are not due to shadow from the depression, will not improve with filler injection.

Fillers are usually not for dark circles. Usually fillers are for tear trough depression treatment. Best of luck.

Dark circles are not usually improved by fillers.  Fillers will improve the tear trough depression. Best of luck.

Dear christopher33yo,

Thank you for your clinical post. Injection of soft tissue filler in the lower
lid to correct tear trough deformity generally results in immediate
improvement. Depending on the product
used some physicians will under inject slightly as there is an absorption of
interstitial fluid into the product, a process called hydrophilia and results
can look even better at one week. If the
filler is injected in the wrong quantity or too superficially, a bluish colour
can persist called the Tyndall effect.
This Tyndall effect will require treatment with enzymes to remove the
product. Generally, injecting your soft
tissue filler product under the muscle of the lower lid will not result in the
Tyndall effect. Occasionally,
hydrophilia will be excessive and you will get a bulge, which is worse than the
lower tear trough deformity and this also needs adjustment. Finally, persistent blue colour is often a
product of accumulation of tiny veins, which are present and visible
pre-treatment and this is called venous engorgement. Venous engorgement responds to long pulse YAG
lasers at the time of the tear trough filler.

There are many tricks and nuances to
treating the lower lid and seeking out an experienced lower lid injection
physician is important.

I would revisit this with your
injection physician and see if they can lead you to an acceptable aesthetic
result. There are many products for the
lower lid that work well, Restylane, Belotero, some of the Princess products
and even Teosyal.

The product is less important than
the injector and the strategy. I’m sure you’ll get an excellent
result and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto