Expectations of Under Eye Filler Treatment, and Minimizing its Risks

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New York Oculoplastic surgeon Amiya Prasad, MD reviews the expectations and risks of under eye filler treatment for hollowness and puffy eyes, how he minimizes the risks of this procedure, and treating the associated issues such as cheek hollowing and dark under circles:
0:20 - How Dr. Prasad administers under fillers for hollowness, to camouflage eye bags, and also for wrinkles
0:32 - How under eye filler results can be seen right after the procedure
0:47 - How Dr. Prasad often sees patients who had filler done elsewhere, and are dealing with complications like swelling, lumps, and irregularities, as well as sub-par results
1:10 - Dr. Prasad’s training and experience as a specialist in cosmetic eyelid surgery, and revision surgery to correct work of other doctors
1:53 - Dr. Prasad’s experience in non-surgical injectable treatments around the eye area for crow’s feet, upper eyelids, and lips
2:03 - How Dr. Prasad uses a technique for deep placement of thicker fillers for the cheekbones, jawline, and chin
2:23 - How permanent options are a common question since fillers are metabolized
2:38 - How Dr. Prasad performs tear trough implant surgery, but they are not permanent since facial dimensions change with age
3:00 - How patients appreciate the convenience, safety, and reversibility of facial fillers
3:18 - How Dr. Prasad uses the principles of facial implant surgery in the deep placement of facial fillers, but fillers are more precise than implants
3:39 - Factors of the under eye area to be considered in filler placement, like bruising
3:55 - How Dr. Prasad minimizes the chance of bruising by using blunt cannulas instead of needles
4:10 - How Dr. Prasad approaches filler treatment the same as surgical procedures
4:26 - The rare but serious risk of vascular occlusion from filler being injected into a blood vessel or artery
4:38 - The increase of practitioners performing under eye fillers without specialized training, leading to higher incidence of complications
4:55 - How risks of under eye filler placement can be minimized by the skill and training of the performing doctor
5:10 - Risk of infection in filler placement from skin surface bacteria
5:27 - Risk of encapsulation of filler, and how it’s treated
5:40 - How under eye hollowing is often accompanied by dark circles, and how it’s treated with platelet-rich plasma (PRP)
6:12 - The synergistic combination of PRP and a hyaluronic acid filler for hollowing and dark circles
6:27 - The popularity of under eye filler treatment for under eye bags, and how they can be used in slight cases
6:54 - How filler can make more significant cases of eye bags worse
7:05 - How filler treatment that made eye bags worse can be dissolved
7:15 - Treatment options for eye bags after filler is dissolved
7:23 - How under eye hollowing can also be related to hollowness in the upper cheek, and how it’s treated with deep filler placement at the cheek
8:01 - How rounded and puffy cheeks from filler placement is avoided by placing filler at the bone level
8:36 - How Dr. Prasad uses his knowledge of facial surgery to address hollowing in the cheeks and under eye area
9:15 - The importance of treating filler treatment like surgery for safety, predictability, and reversibility
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[@sansaar00]

It was so informative especially the part where you told that two therapies can be combined

[@AmiyaPrasadMD]

I'm glad you found the video informative, saloni singh! Thanks for watching!

[@grnddesign]

Someday....I’d love to make an appointment to see you 😊

[@AmiyaPrasadMD]

Hope to see you soon, Lorraine from Miami!

[@marianthipapastergiadis7744]

could you please make a video specifically about under eye wrinkles? for example, what is the best treatment? laser? filler? botox? I keep reading so much contradictory information and I trust you as an expert in this area

[@AmiyaPrasadMD]

Hi maz p, I already did! :) I think this should answer all your questions - kzbin.info/www/bejne/homwmYxvZbmFm68

[@elizabethgardner2341]

Wonderful work Dr.

[@AmiyaPrasadMD]

Thank you for the compliment, elizabeth gardner!

[@rashasarandah1695]

Anyone know of a doctor as good as him in the Orlando, Florida area? Not sure if I need to go to a Derm or plastic surgeon. Also they always assign their nurse to do it when the dr is busy. Should that worry me? Wish I knew who to trust in my area!

[@AmiyaPrasadMD]

Hi Rasha Sarandah, If you would come see us in New York, I would do your filler treatment personally, and I generally don't have my nurses or assistants placing filler in patients, although they do other injectables like anesthetic. Many doctors don't place filler in the eye area as it is highly delicate, so you do want a doctor who does eyelid surgery regularly also placing filler in this area. I suggest you ask straight out for a doctor who does eyelid surgery regularly, and have them do your possible filler treatment. I hope this helps you.

[@mobiletherapeuticsbyshaniq8501]

So informative. I don't live in USA. You are great. Best to have someone like you doing undereye filler What you suggest filling undereye hallow with? The undereye is thin and has fat loss.

[@AmiyaPrasadMD]

Hi Mobile Therapeutics By Shanique, Thanks for watching! I usually use a softer hyaluronic acid filler like Restylane-L, or Juvederm Ultra for the lower eyelids, but as you and the video state, it's the doctor doing it that determines results, not the material. Softer hyaluronic acid fillers are appropriate for this area for facial movement and expressions. I hope this clarifies things for you.

[@carriewolf3597]

Thank you! I wish you were in my town.

[@AmiyaPrasadMD]

You're welcome, Carrie Wolf! I'm glad you found the video helpful!

[@shayyumi3353]

I wish i could visit your clinic soon. Guess i’ll start saving now! 😬😅Ur videos are awesome as always! Very informative!

[@AmiyaPrasadMD]

Thank you for watching, Shay Yumi! I hope to see you soon!

[@Emsyaz]

You already look so pretty. What treatment are you thinking about?

[@originalDNAgirl]

Thank you. Super informative.

[@AmiyaPrasadMD]

You're welcome, originalDNAgirl! I'm glad you found the video helpful!

[@75vasso]

hi, always a pleasure to watch your videos. very informative, educational. the way you present things and details is just wonderful. thank you for that. also i wanted to ask you, if you have ever used profilo? what effect does it have, and are there any side effects? thank you so much.

[@AmiyaPrasadMD]

Thank you for watching, 75vasso! Glad you find the videos informative! Profhilo is not something I use in my practice, so it's something I have to look into more before offering an opinion on it.

[@75vasso]

@@AmiyaPrasadMD Thank you, I will be looking forward to it.

[@AmiyaPrasadMD]

You're welcome,@@75vasso!

[@natalie5165]

Hi Doctor! Great informative video, thank you! What is your opinion on some of the newer research suggesting that filler can migrate around the face and be found within facial pockets 5-7 years after initial injection? The Victorian Cosmetic Institute here on KZbin just released a video on this, would love to hear your professional opinion?

[@AmiyaPrasadMD]

Hi Natalie Opasinis, It is certainly possible for hyaluronic acid fillers to be encapsulated to prevent being metabolized, and stay in the body for years. As described in the video you cited, as well as my own video I published in 2016, they still can be dissolved - kzbin.info/www/bejne/omfYkGiBr5qgaNU

[@AmiyaPrasadMD]

Hi@@RoseGold-db6xe, Hyaluronic acid fillers last 1-2 years, depending on the thickness of the filler, as well as the rate the individual metabolizes it. In cases of encapsulation, one should seek an expert injector to dissolve the filler so it does not stay in the body longer than intended. I hope this clarifies things for you.

[@aryanandan_]

Hoping to visit you soon from India

[@AmiyaPrasadMD]

I hope to see you soon, Arya Nandan!

[@elaineworsfold3755]

Another informative and honest video thank you dr elaine Lincolnshire uk

[@AmiyaPrasadMD]

Thanks you Dr. Elaine! Glad you found the video helpful!

[@candywhite7149]

Where is your office located? I mean your clinic, I would like to have a consultation with you. I'm considering Fillers around the eyes.

[@AmiyaPrasadMD]

Hi candy white, Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@Rohit.Panchal]

Hello sir, Thanks for making such as informative videos.. nobody on KZbin like you...i always follow your suggestion.. can you help me here does hyaluronic acid serum is good for under eye wrinkles and bags.. does it reduce/remove permanently

[@AmiyaPrasadMD]

Hi Rohit Panchal, No, hyaluornic acid serum will not treat eye bags, or under eye wrinkles permanently. The only long-term solution for eye bags that are present all time is surgery to remove and sculpt the fat that causes them. There are various ways to improve under eye wrinkles without surgery like lasers, radiofrequency, fillers, and PRP, but no treatment stops aging. You can refer to these videos for more detailed answers to your questions: kzbin.info/www/bejne/navHhZ9tgJugZ7c kzbin.info/www/bejne/r6TdoY2JhKp6pbM kzbin.info/www/bejne/homwmYxvZbmFm68

[@Rohit.Panchal]

@@AmiyaPrasadMD Thank You So Much Sir...

[@AmiyaPrasadMD]

You're welcome,@@Rohit.Panchal!

[@jennyquezada9644]

Can encapsulation happen or show even if placed at the bone level?

[@AmiyaPrasadMD]

Hi Jenny Quezada, Encapsulation of filler can happen at any level. I hope this clarifies things for you.

[@chiquithepom]

Hello Dr. Prazad, can you use juvederm voluma on tear trough?

[@AmiyaPrasadMD]

Hi chiquithepom pom, No because Juvederm Voluma is a thicker filler designed for areas with little facial movement such as the cheeks, chin, and jawline. A softer, more malleable filler is appropriate for the tear trough like Restylane - L or Juvederm XC. I hope this clarifies things for you.

[@chiquithepom]

Thanks a lot Dr. Prasad.

[@mcsteven6509]

I have a very important question doctor? Well, my question is that the majority of us are born with asymmetrical eyes. The left eye might be smaller than the right eye. So my question is by injecting fillers will the eyes get smaller or bigger. Second question is can fillers be injected to the temple area and can fillers lift your face

[@AmiyaPrasadMD]

Hi Mc Steven, I don't recommend filler treatment for normal eye asymmetry, only for issues like hollowing in the lower or upper eyelid. Filler can be injected into the temples for hollowing. As for lifting the face, fillers can lift the skin away from the face because of facial volume loss due to aging, but fillers cannot replace a surgical facelift. You can refer to these videos about facial fillers used for a lifting effect: kzbin.info/www/bejne/pJ3UdGV-a8RskKM kzbin.info/www/bejne/qHTNpoh3pMt4fLc kzbin.info/www/bejne/n5exqICGaN94Zrc

[@mcsteven6509]

@@AmiyaPrasadMD i have very hollow lower eyelid. Do you think 1 full syringe of fillers would be enough or can you please tell the maximum number of fillers a person can inject to their under eyes

[@AmiyaPrasadMD]

Hi@@mcsteven6509, A full syringe is certainly possible as it is only 1ml. The maximum amount would depend on the hollowing in both the tear trough as well as the cheek, so it really depends on not only the under eye area, but adjacent hollowness as well. I hope this clarifies things for you.

[@tamih532]

Thank you for a great video, I love your content. Approximately how long should I expect my undereye filler to last before a touchup is required?

[@AmiyaPrasadMD]

Hi T Howerton, Thank you for watching! Softer hyaluronic acid fillers used under the eyes usually last about a year, but the rate they are metabolized varies with individuals, so it may be a little longer or shorter than that. I hope this clarifies things for you.

[@juliadixon4810]

An injector is trying to sell me on Radiesse for the undereye trough. Thoughts?

[@AmiyaPrasadMD]

Hi Julia Dixon, Radiesse is too rigid a filler for the under eye area, which requires a lot of movement for facial expressions. I would recommend a softer hyaluornic acid filler for the tear troughs, like Restylane-L or Juvederm XC. Unlike hyaluronic acid fillers, Radiesse is not reversible or dissolvable, and some material will remain after its effective life of about 1 year. I hope this clarifies things for you.

[@lilac6411]

Is there a safe long lasting filler for checks?

[@AmiyaPrasadMD]

Hi Lila C, Hyaluronic acid fillers are generally the safest cosmetic fillers since they are safely metabolized by the body, hyaluronic acid naturally exists in the body so they are hypoallergenic and readily accepted, and can be dissolved if needed. Juvederm Voluma is the longest lasting hyaluronic acid filler, and is specifically designed for the cheeks. Voluma can last up to two years. I hope this clarifies things for you.

[@lilac6411]

@@AmiyaPrasadMD Thanks for the reply one more question? Is having wisdom teeth removal at 31 damage the fat in the face ? Or causes bone loss?

[@AmiyaPrasadMD]

Hi@@lilac6411, No, wisdom teeth extraction will not affect facial volume loss of fat and bone. I hope this clarifies things for you.

[@uzma__noor__official3625]

How much does this cause???? Plz rply

[@AmiyaPrasadMD]

Hi Uzma__ Noor __official, There are no fixed costs for treatment as price depends on the extent of treatment and amount of filler material needed, so a physical exam is required before we determine the cost. I hope this clarifies things for you.

[@appleberry1024]

❤

[@NikkiJayArtistry]

Found this after botched filler job by board certified plastic surgeon

[@AmiyaPrasadMD]

Hi Nikki Jay Artistry, Sorry to hear that, but being a board-certified plastic surgeon means they are tested for procedures from head-to-toe, so they are not necessarily experts in treatments for the eye area and eyelids. I hope this helps you.

[@NikkiJayArtistry]

@@AmiyaPrasadMD yes me too .as its my 1st experience and she assured me eye filler was her "specialty"...needless to say I was so excited for the results.. nope.... i have a follow up with her today, after already going back to her twice with unhappy results..she over filled one area, filled it superficially leaving a lump and bruise, the results are uneven on both sides and even my 16 year old can tell its been filled in different amounts on each side... I really just want it dissolved ..but im very very leery at letting her come near me with a needle again... #dilemma

[@AmiyaPrasadMD]

Hi @@NikkiJayArtistry, Sorry to hear that. You can have the filler dissolved by a different doctor, then start all over again with filler treatment. I can help you with that, if you like. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@NikkiJayArtistry]

@@AmiyaPrasadMD ty you much dr. I will be reaching out soon

[@Sandy-zd8vs]

You seem to be an amazing doctor, but your long hair covering your eyes is annoying to watch, lol

[@AmiyaPrasadMD]

I hope my other videos where my hair is cut shorter don't annoy as much, manal kamal.