How qualified are ocuplastic surgeons in performing dermal fillers?

Question

I've consulted with both an oculoplastic surgeon and MD on getting fillers. The oculoplastic surgeon said he didn't think I had a huge need for them while the MD said I could benefit a fair bit. I'm thinking I'm somewhere in between. Anyway I told the MD what the oculoplastic surgeon said and he said that oculoplastic surgeons only “dabble in fillers" and that he "literally does hundreds of injections a week" so he is "far more qualified". I assumed an oculoplastic surgeon WOULD be highly qualified?

Jonathan Kulbersh, MD · Answer

This is a great question. Both of these professionals may have the experience and expertise to administer injections with the precision necessary to achieve the best possible results. In my office, my nurse and physician's assistants also have extensive experience and skill in these procedures. I would focus on how much training and experience a provider has rather than their specific specialty.

Jason Emer, MD · Answer

I suggest consulting a physican who is board-certified and experienced in this.

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now.

There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term.  There are many things you can do to treat under eye hollows and dark circles without surgery.  Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture.  I suggest you get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

The fact is that nonsurgical rejuvenation with injectable fillers, much like it was with neuromodulators, such as Botox, as well as the vast majority of other nonsurgical rejuvenation techniques (over 90%, in fact) were developed by cosmetic dermatologists. However, since their introduction, most of these nonsurgical approaches were subsequently taught to plastic surgeons, facial plastic surgeons, oculoplastic and ENT plastic surgeons and even to oral surgeons--the so-called core aesthetic specialties. So, these days, you have your choice of cosmetic physicians to choose from. However, level of experience, as in any field, can play a very important role in shaping the outcome of treatment. A plastic surgeon or oculoplastic surgeon who fits in a few patients for filler injections in between a heavy surgical schedule is not likely to have the same experience as a busy cosmetic dermatologist who exclusively concentrates on nonsurgical injection rejuvenation. Whichever physician you choose to consult, it would be prudent to ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

Tanya T. Khan, MD · Answer

Hi, I am an oculoplastic surgeon and have vast experience in facial fillers. We do a high volume of tear trough injections especially, which is a highly specialized anatomy of the eyelids and orbit. More than that, we are a high volume injectables practice as well as eyelid surgery. You should specifically research the qualifications of your provider and look at before/after to understand whether you are comfortable having them perform a service on you. Best of luck.

Camille Cash, MD · Answer

When selecting a specialist for your fillers you want to do your research.  Your injector should be knowledgeable and experienced in both facial anatomy and injecting.  Talk with your injector about their qualifications and look at before/after photos.  Select the person with whom you are most comfortable and confident.

Jo Herzog, MD · Answer

The most qualified person to inject fillers is the one that does them all the time as part of their daily routine. An occuloplastic surgeon has a lot of training for operating around the eye and is a highly qualified surgeon  but injecting fillers is not usually their focus. A dermatologist who does this every day will have much more experience with this . A brain surgeon is very well trained and talented surgeon but you don't want them to fix your simple broken arm.

Leonard Grossman, MD · Answer

A good or successful carpenter is not going to become a plumber for a sidekick. The same rule applies in medicine. Doctors who’re  not very successful all of a sudden start to perform procedures that they were not really trained to do. I think “your MD” Is most likely not a plastic surgeon or a dermatologist and his knowledge of the facial anatomy is probably quite poor. I would have any of the treatments you’re interested in performed by a plastic surgeon or a dermatologist since these are the people who are trained in fillers. I hope this helps and good luck from New York City plastic surgery

Robert T. Buchanan, MD (retired) · Answer

I am afraid you have not provided enough information to answer your question or to give you any advice as to who is correct in their assessment of what you need.  From your statements, it is highly likely that you have totally missed the important things that you should have been evaluating.  Those things are how much training the physician has had in anatomy of the area as well as injection techniques and precautions and what there success rates and problems with the injections are.  You said you consulted and MD who says he does a large number of injections.  The thing that you need to know is that there are a lot of MDs out there doing a large number of injections that should not be.  They started doing it because it was easy money and the continued doing so because no one checks their credentials or their results.  Those injectors are some of the reasons that a large number of people on this website are having their fillers dissolved.  In 30 years of doing fillers, I have dissolved some 3 times and all were quite unusual cases.  Sometimes a board certified physician such as an oculoplastic surgeon who knows the anatomy intimately is more qualified to assess you than someone who does not understand that anatomy.  I would suggest that you see a physician who was trained to do fillers in their residency and does so frequently, gets good results, and can show you pictures of people like yourself who they have treated successfully.  I would also ask about problems and complications and how often they wind up dissolving the filler.  There other specific questions you should ask based on exactly what problem you are trying to treat.  I assume, since you saw an oculoplastic surgeon, that you are treating the area around your eye.  If you are treating the under eye area, do not let anyone treat it with a light filler such as Juvederm Ultra or Volbella, Restylene, or Belotero Balance and do not let them place it superficially.  This is an antiquated technique that has significant problems associated with it.