How long does restylane filler last before it begins to degrade for the under eye area?

Question

Correct me if I'm wrong but I hear it lasts 6 months. What does that exactly mean though? Will it slowly degrade over time the moment it's put under my eye, or does it start degrading at the 6 month mark?

Nelson Lee Novick, MD · Answer

I have been injecting the tear troughs with fillers for well over three decades, since the early years with the original Zyderm I collagen filler. In recent years, hyaluronic acid based fillers have captured the filler market and have become the main filler for use in the infraorbital region. Although plain Restylane was at one time routinely used for this purpose, particularly when diluted, more recently Restylane Silk and Belotero Balance (which I use in my Upper East Side Manhattan practice) have become the go-to products, since they are unlikely to give rise to lumpiness, and particularly the latter product possesses little to no tendency engender the unwanted, bluish Tyndall Effect when injected superficially into the delicate skin under the eyes. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I typically opt for Teosyal Redensity II). In my experience, since the region under the eyes is subject to so little mechanical force (even at extreme squinting), the duration of the desired effect of the injected materials tends to be considerably longer, and I have had quite a number of patients who have gone three or more years before needing any additional treatment. I myself went for longer than five years before I needed to retreat my under eyes. Make sure that you consult with a board certified aesthetic physician with experience and expertise in treating the infraorbital region, which is certainly an area not to be left to medspas and physicians accustomed only to treating ordinary smile lines with simple Juvederm or Restylane. Make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.

Kian Karimi, MD, FACS · Answer

Thank you for sharing your question about Restylane. In my experience, filler in the tear trough area can last between 9-12 months. This is because the under eye area is relatively immobile and filler is not metabolized as quickly as other areas. As you mentioned, Restylane is a great product for the under-eye area because it doesn’t draw as much water to it as other products. In my practice, I prefer to inject this area using the microcannula technique, which essentially eliminates bruising and reduces risk of swelling. For more information about under eye filler, I recommend scheduling a consultation with a board-certified specialist who is experienced with the microcannula technique.

Jeffrey R. Raval, MD, FACS, MBA · Answer

Hello,
How long your treatment lasts will depend on factor, such as your skin type, lifestyle, age and the specific results you desire. It also depends on your practitioner’s injection technique and skill. Here are typical timeframes for the following:
Facial lines and facial shaping: follow-up treatment is usually needed after 6-12 months.Lip enhancement: follow-up treatment is normally needed in about 6 months.Skin rejuvenation and deep hydration: after the initial intense treatment of 3 treatment sessions every 2-3 weeks, follow-up sessions are normally recommended around every 6 months.

Aldo Guerra, MD · Answer

Hello Desmond. When I speak to patients about this I'm referring to the results achieved and not the product. In other words, the results the patient can see will likely last 6 months, but there may still be some product in the body for a while longer. Best wishes, Dr. Aldo

Miguel Mascaro, MD · Answer

Very common question.  I find that it lasts anywhere from 1 to 2 years for my patients.  Part of it has to do that it is an area with low motion - that is, the filler gets metabolized very slowly.  Think of HA fillers like filling up your gas tank with gasoline.  As the muscles in the area move, the filler gets metabolized by enzymes in the area.  The more motion (the bigger the engine) the faster the filler gets metabolized (the faster your gasoline goes down).  Most people never wait until their "tank is on empty" for a refill - you will start to notice that the volume needs a little augmenting around after a year plus.  I hope some of this helps! Best of luck.

Mitesh Kapadia, MD, PhD · Answer

Different people metabolize fillers at different rates. In most patients, under eye filler degrades very slowly. Most patients still have most of their under eye filler present 1-2 years after injection, with many patients not needing retreatment for several years. The longevity of filler in this area is probably because the under eye area doesn't move a lot. The same filler placed into the lips is can be gone within three months as the lips are constantly moving. When filler dissolves it slowly gets absorbed by the body. You will not note a sudden reduction in volume.

Steven F. Weiner, MD · Answer

The duration of fillers is highly variable and patient dependant. In the tear trough area, fillers tend to last longer than in more mobile areas. I tell my patients about 12 month duration in this area. I always use a cannula for this area for safety and less bruising. When a filler lasts for 12 months, it starts to degrade much sooner than that. It isn't that the filler just instantly gets metabolized at 12 months. In FDA trials, there is always a decrease over time that is linear, starting about 4 months.

Leslie Pickens, MD · Answer

In my experience filler in the under eyes should last approximately 12 months give or take a couple of months.  Duration is dependent on your age, overall skin condition and maintenance, your state of health, whether you smoke, your genetics, sun exposure and amount of correction performed.  Since there is little movement in this area of the face as compared to cheeks and lips, a longer duration may be expected.

Michael H. Gold, MD · Answer

Thanks for your question.  While there are no FDA studies that show the true longevity of tear trough injections, they have been done long enough that we like to tell our patients that these HA fillers, when injected properly and by experts (board certified dermatologists or plastic surgeons) can have a long lasting effect in many.  Long lasting can mean different things depending on how you do with the filler, how expert the provider is, and which filler is used.  In general, 6-9 months is how long these fillers last here and there will be a slow resolution of them over time.  Some will have longer results and others shorter time periods – again, there are many factors that play here so consult an expert, have the injections done by an expert, and you will enjoy the results of injections in this area.

Hardik Soni, MD · Answer

Thank you for your question. I would say that Restylane under the eyes (tear troughs) typically last 6-12 months. This is an area with low motion therefore the filler gets metabolized very slowly. Careful attention is needed when filling this area, this because you do not want to overfill this area to achieve the best results. I recommend having a consultation with an expert injector to address your concerns and to determine the best treatment plan for you. Best of Luck!

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