There’s been some nice stories done recently about the stuff I’m doing.
It’s good to see that the word is getting out about these procedures.
Here’s some links:
Enjoy!
New Press
Non Surgical Blepharoplasty
I’m considering having filler injected in my under eye circles. I’ve had this done twice before. The first time I loved it (That was a little over a year ago). About a month ago I went to get a touch up from a new Dr. (I moved recently) and I hated the results. It looked like the whole area was just pushed up and not filled in. I also got a blueish hue. I had it dissolved with vitrase. The first doctor used a fine needle to do the injection, while the second used a blunt cannula. I wasn’t aware that there is a risk for blindness until I went to the second dr who said using a needle can increase risk for injecting into a blood vessel. This has me scared and uncertain as to what to do. My hollows really really bother me. The second dr. seemed to convey the chance of injecting into a vessel with a blunt were near impossible and that it was very safe through this technique. Yet I hated her results. I’m not sure if it had anything to do with the needle vs blunt or if her technique was just off. Now in doing research, I’m overwhelmed with information. I’m seeing different safety precautions that can be used. (Withdraw the needle to ensure not in a vessel, use blunt tip, use epinephrine) I’m also reading about different aesthetic techniques (under the muscle, above the muslce, multi-planar, Thread behind the needle, push the needle forward while injecting). I really don’t know what I should be looking for in a surgeon. And I absolutely do not want to have surgery. First and foremost i’m concerned about safety. Clearly I don’t want to trade my under eye circles for blindness. Yet I’m sick and tired of having people asking whats wrong- you like tired or sick. I’m looking for a dr. to tell me if there are techniques that eliminate the risk for blindness (if not eliminate, minimize)?
You need to find a doctor who is very experienced in this technique. experience matters more than philosophizing about theoretical dangers of blindness. i have injected filler (always hyaluronic acid and always using a regular, sharp needle) under the eyes of about 1200 patients and have never had a serious complication. i have not seen a single case of blindness from filler injection under the eye reported in the literature. the artery is so small and the risk so remote that sacrificing good results to prevent this unheard of complication seems silly. insist on seeing the doctor’s before and after pictures to evaluate their aesthetic sense and to make sure that they have done enough cases to show some good ones. if you’d like me to take a look at your pictures, i would be happy to.
Juvederm or Restylane Under the Eyes
Dear Dr. Rivkin,
I have seen you televised on many reputable shows, and have also followed your threads on this website. Therefore, I have decided to pose this question to you instead of other doctors. (Thank you for all your great and candid posts!)
If I am considering an injectable for hollowing of the eye area, such as Restylane or Juvederm, is it reasonable for me to ask a doctor or nurse (injector) to first inject me in an unnoticeable area (such as my hand) to guage my body’s reaction to the material?
Because I have had eczema in the past, with much itching, I am concerned that I may have an allergic reaction to injectables. (Bumps are also a concern, as I have thin skin) I am thinking that this type of request would seem normal to doctors, but I have never read about anyone asking for a “test injection.”
hi emii,
you can certainly ask for a test injection and i’m sure any reputable doc or injector will do it. be sure to go to someone who has a bunch of experience with the procedure, preferably that you can see with before and after pictures. i have never seen any allergic reactions to restylane or juvederm, even with eczema patients, and i’ve probably done about 1000 eye patients.
also, the person you go to must have be comfortable working with hyaluronidase – the enzyme that dissolves the restylane or juvederm just in case you get a bump or a bit of over injection (it happens to the best injectors)
hope that helps
Tear Trough Fillers
What can you say about which one is more appropriate filler for under eyelid and tear through ?
One doctor said Perlane, the other doctor said Redexis.
By your experience which one can fill up better looking and longer ?
Thanks,
MaryNicole
hi mary nicole,
i don’t think there is much debate these days about what material is best under the eyes. hyaluronic acid works really well and lasts for a long time – over a year and sometimes as long as long as 3 years. i prefer juvederm ultra to perlane and restylane – i get smoother results – but that’s just my preference. its perfectly ok to use the other substances if the doctor wants.
what is not ok is to use radiesse in the tear troughs. there is no reason to do so, since radiesse is more likely to form bumps, it is more likely to show through the skin as a white stripe and radiesse cannot be reversed with enzyme like juvederm or restylane or perlane.
i have probably done about 1000 tear trough cases and i have never had a serious problem with juvederm or restylane.
hope that helps
Discoloration Under the Eyes After Juvederm
Hi,
I had juvederm in sept07 for some dark circles. Dr. told me to fill the hollow and it would get rid of the shadow. One month later there was an imperfection on one undeye(dent) so she talked me into filling it with restalyne. She hit a blood vessel on the l eye and I had a black eye for 5 wks. When it cleared, there was still a very dark mark where the black yey had been It did not get lighter and she said it was a hemosidirin stain and lets try to laser it. She laser it 2x and it helped lighten the bottom but there is still a discoloration I never had before. The other eye strated to get a discoloration under it also. It became worse than the other side. It looks like 2 dark lines that where drawn from my eye to the side ofthe nose. They are MUCH more noticable than any dark circles I used to worry about. They are VERY distinct in photos and I look like an exhausted mug shot. I reviewed all my photos prior to the injections and you cannot see any darkness or distortions under my eye. I guess the dark circles bothered me in the mirror but they were nothing compared to what I am dealing with now. I look terrible in photos and it is quite noticable in person. There is a slight bump on the right side but I can live with bumps. Its the discoloration (darkbrownish) that has me terrified. I am afraid I ruined my face. All over a little dark circles. I would give anything to have my face back. Any ideas? The 2 syringes of juv were 9/07 and the resty on top of it was 11/07.
Thank you for your help!
hi
sorry – i was on vacation
the discoloration that you are describing is a rare but really disturbing side effect of injecting restylane or juvederm under the eyes. i’m not sure why it happens – probably the filler becomes visible through the skin (it is clear, but looks blue under the skin). did your doctor inject deep, next to the bone? if she injected too superficially, it is possible that the filler becomes visible like this.
the filler is still there, so i would dissolve it with hyaluronidase enzyme if i were you. if your doctor is injecting under the eyes, she should be familiar with the enzyme. it will remove the filler and your eyes should go back to normal.
cheers
Red after Chemical Peel and Blepharoplasty Question
I have had 4 deep chemical peels done to remove severe acne scarring over the past 7 years. After the last one my skin has stayed bright red. It has been almost a year now and it is not fading. I now have to always use a moisturizer with a green tint and thick waterproof makeup in order to cover it up and it still looks red in pictures. I won’t even let my husband see me without makeup. I am scared to go swimming with my kids because the makeup might wash off. I had the chemical peels so I wouldn’t have to wear so much makeup. What would be the best treatment to get rid of the red?
Also I am 37 and have droopy upper eyelids, they almost rest on my upper lashes. The are not crepey but just a fold. Is there something I could do other than eye surgery?
That’s a long time to be red! You should not have to suffer through this without help.
I would go to your dermatologist and ask their advice about the redness. IPL photofacial or YAG laser treatment would be a good idea for you. You will probably need several treatments, but it is worth it.
By the way, you may want to speak to the office that did your last peel. This is a problem that they had a hand in causing, so they may want to take some responsibility in fixing it.
In terms of your eyes, I do not think that you are going to get away from having a blepharoplasty (eyelid surgery) – there’s no way to tighten that skin non-surgically. The good news is that it sounds like you have an issue that insurance may cover: when the skin folds over so much that it interferes with vision, medical insurance will cover the procedure. I would speak with an oculoplastic specialist.
Hope that helps.
