A tear trough filler question (under the eyes)
A patient recently called me (who lives relatively far away from Modesto) to see if I can give her a second opinion regarding restylane under the eyes. She has a local injector (local to her) who wants to inject restylane under her eyes and she wanted to know why we don’t do restylane under the eyes. Here are some thoughts I had.
I would tell her that I think that any product could work well under the eye in the tear trough region with a skillful injection artist. The more important factor is the artist who injects under the eye. There are so many things you can do with a filler (off-label FDA) – such as dilute the filler or add lidocaine/epinephrine or inject deep or use a cannula, etc.
The filler product is like the violin without the violinist.
Restylane in my hands is excellent under the eyes – I have even used it before quite frequently and was very happy with the results. I personally prefer Belotero because in my hands currently because it results in a smoother contour. The edges are not as aparent to me if I have some superficial injections. My technique is usually to inject deep. But some patients need a thicker fill under the eyes, and thus they would be better served with Restylane – which also lasts longer than belotero under the eyes.
Because of the smoother contours, I prefer belotero under the eyes rather than Restylane. This is only a personal preference and it is my current preference which can/will change with time and further experience and further feedback from patients.
The reason I don’t carry Restylane, it’s because it’s a product that is very similar to Belotero and Juvederm. Similar enough that I don’t really see a point in having it in my practice, and I have received poor customer service from the Restylane company in the past, and thus I chose not to carry their products for the past 6 years.
Juvederm under the eyes, in my opinion causes a bluish hue (tyndall effect) in the hands of many surgeons/doctors/injectors including myself. I have rarely experienced this problem, but because other surgeons have reported this more often than I’d like to hear. Thus I tend to stay away from Juvederm for under the eyes.
The under eye filling with any filler is consider off-label FDA usage, and thus there won’t be a ton of information about this because companies are technically prohibited from advertising off-label FDA uses of products.
I think she would be fine getting Restylane if she trusts her injector. I am not able to comment on the skills of other injectors because I don’t know how they inject. Please continue to see your injector in person for detailed information. I would welcome another visit to our office to continue the conversation if that were convenient.
Disclaimer: The above is medical information. It’s not intended to be advice. Please see your doctor/injector in person for personalized advice.