My patients often ask me “What can I do to enhance my appearance that won’t break the bank?” Again and again I find myself highlighting the aesthetic power of facial volume and in particular, replenishing volume under the eyes.
There is simply no other intervention that can be done in an office, with minimal disruption to one’s busy life and provide such meaningful facial enhancement at such an affordable price.
A loss of volume under the eyes and in the mid-face makes us look older, tired, and can accentuate dark circles by creating a shadow. It can also exacerbate lower eyelid puffiness that many individuals develop, by creating a “valley” just beneath the “hill” caused by fat protruding forward from behind the eyelid. Though commonly seen in people in their fifties and older, these changes can also be seen in much younger patients who have an hereditary absence of mid-face volume which makes their faces look flat and washed out.
There are several FDA approved fillers as well as one’s own fat that can be safely injected into the hollowness under the eyes that has come to be known as the tear trough. With that said, my filler of choice for this particular facial area is Restylane®, which is cross-linked hyaluronic acid that is found naturally in our skin. This material is injected just above the bone and plumps all of the soft tissues to create a natural, youthful fullness in this area. Since the tear trough is such an aesthetic focal point, an artist’s eye and millimeter specificity are required when treating this area. The effect is to visually shorten the lower eyelid, create a smooth transition from the eyelid to the cheek, lift the cheek and create a healthy, youthful fullness to the mid-face.
To optimize the effects one must prepare for the procedure. It is recommended that you avoid medications and supplements that are known to thin your blood for one week prior to your treatment to help reduce post-operative bruising. These include vitamin E, aspirin products and non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen. If you are taking physician prescribed blood thinners please inform your doctor before proceeding. Prior to injecting the filler, the area will be numbed, making the injections pain free. After the procedure, Arnica Montana is provided to further reduce bruising. However, you should expect several days of mild bruising and swelling. Patients usually look optimum at one week following the procedure. Results generally last about 18 months, though I have seen patients who still looked great at 24 months.
If you feel like your face has lost some luster, speak with your facial plastic surgeon about tear trough fillers. It might be just what the doctor orders.
Seth A. Yellin, M.D., F.A.C.S.
