I often am asked if there is anything patients can do about the bags under the eyes in a “no down-time” treatment. Usually, that can be a difficult question to answer without a very detailed set of functional pictures or an in office exam. However, I can say that most patients over the age of 35 to 40 start to have gravitational changes in the lower eyelids. This leaves the orbital lower eyelid bone very exposed after the youthful muscles and plump skin start descending into the cheek.
One option for addressing this very nicely is injecting a dermal filler into the tear trough (nasojugal groove) using nothing but ice topically applied a few moments prior to injection.
I tend to recommend hyaluronic acid products that are natural for this area. Essentially these are the proteins in the base of the skin that absorb water and help to gently lift the skin and relieve the deep grooves and circles of the lower eyelid.
Of the hyaluronic acid products currently approved by the FDA for facial augmentation, I tend to recommend Restylane (Medicis, corp., Scottsdale, AZ). In the last 8 years, I have seen this product outperform others with my injections. I see very little Tindle effect (blue hue where filler is placed under thin skin) and very few volume corrections after injection. The Tindle effect is less common based on the inherent qualities of Restlyane.
Bruising is possible but very unlikely. Most patients do well with about 0.2 to 0.3 cc placed into each tear trough. Injection to full correction usually takes less than ten minutes.
Most reassuring to many patients is the fact that hyaluronic acid products can be dissolved after placement with an enzyme within about 20 minutes. Although this is very rare, many patients are comforted by the fact that these changes are readily reversible.
Call anytime if you have questions about this fantastic and proven product.
Dr. Todd Hobgood