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Facial fillers, such as Restylane, Juvederm, and Belotero, among others, are proven to improve the appearance of tear trough deformities, but the Food and Drug Administration (FDA) has yet to approve a gel filler for such indication. Restylane products are licensed for wrinkle correction and volume loss but not for under eye injection. Since it’s not illegal to use FDA-approved products off-label, many cosmetic surgeons use Restylane to correct tear trough problems, including dark under eyes, eye bags, and tear trough hollowing.
There are many research trials and clinical evidence supporting the off-label usage of Restylane and other hyaluronic acid fillers for tear trough injection. In one study, patients who were treated with HA filler were assessed after one, six, and 12 months to evaluate the presence of gel filler in the treated areas. The most interesting thing is that after an ultrasound evaluation, the authors found that some fillers remain present in the tear trough for as long as three years. This validated the clinical observation that HA fillers continue to provide beneficial effects way past its standard duration, and that patients will require less product in this area overtime.
The normal aging process makes us lose hyaluronic acid and collagen in the skin, and it is somehow evident in the tear trough—the area beneath the eyelid and just above the cheek. You may have dark circles or bags under the eyes, making you look sick or tired, according to your friends. Patients who want to improve the appearance of this area without going under the knife may choose Restylane filler injection. Many plastic surgeons choose Restylane over any other filler because it provides natural-looking results that are consistent and predictable. Aside from filling the hollow areas of the tear trough, it can also reduce lines and wrinkles to keep the under eyes smoother and more youthful-looking. In terms of longevity, Restylane fillers in the tear trough typically last up to 12 months. While the results are often immediate after injection, it can take up to two weeks to see the full effect of the filler.
Because the skin under the eyes is too sensitive and thin, it can be prone to bruising. Dermal filler injection is difficult in this area as the hydrophilic nature of hyaluronic acid can cause lumps or irregularities. Some injectors skip the needles and use cannulae when injecting in the tear troughs so that patients will experience less pain and bruising. A micro cannula is a thin, flexible device with a blunt tip. The skin is initially pierced with a needle to make an entry point, as the round tip of the cannula cannot pierce the skin. To reach areas under the skin, the cannula pass through the entry point and re-enter without making another needle puncture. More importantly, the blunt-tipped cannula cannot pierce an artery or vein so intravascular injection is prevented. Injecting via cannula may take longer than needle injection but the pain-free and bruise-free process is preferred by most patients. However, using a cannula requires proper training and an unskilled injector can misplace the filler or create more lumping and bruising.
Disclaimer: These articles, and any views and opinions expressed, are not endorsed by Raskel Medical. The articles are strictly for informational purposes and should not be considered medical advice. Raskel Medical does not check or edit the content of these articles for medical accuracy. Contact your medical practitioner for any medical advice needed.