How many vials of filler needed for deep tear troughs? (photo)

Question

I had .5ml of Restalyne placed under each eye but it dissolved or didn’t have any results. Went back to the injector and she recommended Lyft and we did .5ml under each eye. Worked better but you can see my after picture it is barely anything noticeable compared to before. She is now telling me we should try Voluma or another round of Lyft because they have the highest G-Prime and lifting. My question is how many vials do I really need and what would be the best filler

Nima Shemirani, MD · Answer

Hi @ms988924. Thank you for sending your photos. 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!

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind, a combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non-surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long-term goals. Best, Dr. Emer

Trevor M. Born, MD · Answer

Dear ms9888924Thank you for your questions and photos!  Its hard to tell. My preference is Restylane injected on the bone- acting like an implant .  When the filler is placed superficial - it tends to become puffy over  time.With Warm RegardsTrevor M Born MD

Nelson Lee Novick, MD · Answer

Unfortunately, the cropped photos provided do not provide adequate visualization of the surrounding cheeks, which serve as a critical buttress and support for the under eye area. Not uncommonly, simply reflating the surrounding cheeks areas will provide sufficient support to the infraorbital region so as to obviate the need for direct treatment of the infraorbital area or reduce significantly the amount of material needed to achieve a gratifying correction. As to your lack of success so far, this may result from improper placement of the material. What I can say is that you have apparently been fortunate not to suffer from the lumps and bumps that often result from the use of Restylane or certainly the more robust and lifting Restylane Lyft when inappropriately used for treating this region. For this reason, I would be extremely cautious about using Voluma under the eyes as this product is one of the most robust products and more difficult to dissolve should there be a problem. Belotero Balance is my choice for this region, since it possesses little to no tendency to give rise to the unwanted bluish/gray Tyndall Effect when injected into this very delicate region. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would opt for Teosyal Redensity II).  Frankly, I am puzzled by your lack of response and would suggest that you seek a second opinion by a board certified aesthetic physician and make sure to insist upon seeing his/her personal befores and afters before agreeing to proceed. Best of luck.

Blue Medi Spa - Sherman Oaks - Account Suspended · Answer

Thank you for your question.  It is difficult to judge from only the two photographs provided, but based on these photos alone it actually looks as if you have been over filled.  In the medial tear trough there appears to be a protrusion that is creating a hollowness above.  I would not advise more filler if anything you may need to dissolve some with hyaluronidase in this area.
However, the best way to find out which treatment is right for you is through a consultation with a board certified injector. Best of luck!

Monika Soni, MD · Answer

Thank you for the question. In general, I have good result use 1 syrinage of Belotero to treat tear troughs, other option is Juvederm Volbella XC 1 syringe. I usually use cannula to deliver the filler to tear trough area in a very controlled even way. At this stage of your treatment, I would recommand adding PRF and mix with the filler in ratio of 1/2 : 1 . Good luck.

Lake Oswego Vein and Aesthetic-LOVA

Shaun Patel, MD · Answer

I usually recommend starting with 1 (1 mL) syringe of Restylane when treating the undereyes. Your photos are limited but it looks like the tear trough has been filler. Remember, filler does not address skin pigmentation, just hollowing. Without evaluating you in person, I would not recommend additional filler treatment.

Mohammed F. Ahmad, MD · Answer

Hello. You have deep tear troughs but I would have expected more results from 2.0mL of filler. I would suggest finding a different injector and trying Vollure under your eyes. You may need 1-2 syringes.

Jyoti Gupta, MD · Answer

I usually combine cheek augmentation alongwith tear trough filler to correct the tear trough. The results look more natural and decreases the requirement of excessive filler in the to be placed on the underlying area. 
In my opinion 2 ml of filler directly injected in the teat trough area is more than enough to correct the tear trough. Looking at your pictures the placement of your filler is looking very superficial which is to be avoided in this region. I would advise you to consult and have a second opinion from another certified doctor who is an expert in doing fillers as this is a very sensitive area and requires high skill to give proper results.

Maha S. Shakir, MD, FACS · Answer

Thank you for the question. In general, I have good result use 1 syrinage of Belotero to treat tear troughs, other option is Juvederm Volbella XC 1 syringe. I usually use cannula to deliver the filler to tear trough area in a very controlled even way. At this stage of your treatment, I would recommand adding PRF and mix with the filler in ratio of 1/2 : 1 . Good luck.

Lake Oswego Vein and Aesthetic-LOVA

Lake Oswego Vein and Aesthetic-LOVA

How many vials of filler needed for deep tear troughs? (photo)

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