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Non Surgical Blepharoplasty

September 30, 2008
Is Juvederm best injected deeply or just under the surface of the skin for the hollows under the eyes/tear trough area? Is one less likely to created a baggy look? Is a numbing cream sufficient for painless injections or are numbing injections necessary too?
I'm trying to locate a doctor in Orange County who won't create undereye bags but with a minimal amount of pain.

This is a procedure that I perform daily. After trying all the different techniques, it has become pretty clear that some work better than others. This is a tricky procedure - even the smallest over injection can leave an unsightly lump. It takes experience and some skill to do it right.

I like Juvederm a bit more than Restylane. In my experience under the eyes, the Juvederm is a bit smoother and is a little less likely to leave lumps. The difference is not that important, however, as long as either product is injected slowly and carefully deep on top of the bone. I agree that massage just after injection should be kept to a minimum. I have not seen Juvederm to migrate.

Numbing cream should be fine - I would not suggest the use of numbing injections. It distorts the anatomy and is not needed.

I like to bring my patients back after 2 weeks to inspect the results and offer them a touch up treatment if needed. If there is some lumpiness, I can sometimes massage it down. If it is puffy, I can inject a bit of hyaluronidase and dissolve some of the Juvederm. So, if done well, this is a very effective procedure and there is minimal risk because any problems with the results can always be corrected.

Because it is a tricky procedure, you should do your research and choose a doctor who comes highly recommended and is very experienced in this particular procedure. A board certified plastic surgeon who does breast augmentation all day is NOT the person who should be injecting your under eyes. When you consult with your doctor, i would insist on seeing before and after pictures. The results should be natural and smooth.

Hope that helps!

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