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Long-term treatment for under-eye hollows?
I am so tired of these ugly tear-trough hollows that make me look so much older. My dermatologist
recommended Restylane injections. It's cost beneficial for my doctor if I keep getting
these injections, but not for me. I would rather pay a lump sum for something that will
benefit me longer term. What would you recommend? I am 25 years old, and I have never had any
cosmetic surgery or injections. Please see pictures, and thank you!
Thank you for your question!
You're 25 years old and you're looking for long-term solution for the under eye hollows.
You mentioned in your question that your dermatologist recommended restylane injections and that
there is a financial incentive for the dermatologist to have you return. Naturally, you want something
that's more long-term benefit.
As a cosmetic oculofacial plastic surgeon specializing in this area, I have a lot of
experience with the tear trough area and also being boarded with facial cosmetic surgery
and doing a lot of facial procedures where there is cheek implants, chin implant and
facelift, I have a lot of experience with different modalities over the 20 years of
being in practice. The fillers, the hyaluronic acid fillers have actually provided a very
unique benefit for area that used to be frustrating. I come from a time when the tear trough area
we would actually select a certain a small percentage of patients to be a candidate for
a permanent silicone implant. We have come a long way from the benefits of hyaluronic
acid. Certainly, what your dermatologist recommended is within the standard of care.
There are some things that you can learn about the long-term benefits of hyaluronic acid.
We see patients where we can inject hyaluronic acid alone and see the results last for 6
months to a year. There is some individual variations as to the longevity of a hyaluronic
acid.
Something that we have been doing in our practice is we have combining hyaluronic acid with
platelet-rich plasma. Being a very active with the regenerative medicine field as it
pertains to our specialty for example we're using platelet-rich plasma combined with extracellular
matrix for hair loss and we're using this combination for volume correction is acne
scars as well. For the tear trough area, the reason why I'm doing this is that platelet-rich
plasma actually stimulates the body's own vascular endothelial growth factors and collagen.
Platelets are cells in the blood that are necessary for healing like in a cut. So what
we do is we draw your blood, we spin it and we concentrate the platelets and the plasma
that is carrying the platelets so that we can mimic the healing response to restore
quality of the skin and volume. So there is some more long-term permanence to this type
of procedure in our experience because what we do is the real improvement in the skin
quality.
When you look at yourself at the tear trough area, much of the under eye hollowing is also
due to skin type. You're skin is naturally very thin. You're only 25 so you don't have
as of yet, age related changes. But skin quality is very thin. So I find that in selective
patients, I would combine PRP with hyaluronic acid rather than just hyaluronic acid alone.
So that's a concept for you to think about and learn more about.
At this time, the hyaluronic acid fillers are really quite a benefit for selective patients
that are appropriate for. I think that you have to find a doctor that you trust that
you feel is not driven by purely financial incentive. Because trust and maintenance are
important. When you are dealing with something that cannot be surgically treated definitely,
then there are a lot of things that we can't surgically that we can do very well with injectables.
So there's a balance. So find a doctor that you feel comfortable with. I would say someone
who gives you a lot of time and analysis and understand what the risks and benefits are.
I hope the information about the PRP is helpful in your educational process. I wish you the
best of luck and thank you for your question!