Dr Amiya knows exactly what I’m talking about. He clearly would be an example of an excellent choice for this procedure as he has both a flawless understanding of the anatomy/physiology, and has an eye for artistic detail when it comes to a “natural result” and how to achieve this successfully.
I'm an Italian Doctor and I was looking for a clear explanation about some issuew with fillers: I must say that your explanation is great and I would love to be your patient if I would live in USA.
I live in Baltimore and saw him in the Virginia office for the same issue (w/Juvederm). That's after paying 2 other Docs and no resolution. I finally look normal again. #Thanks
Thank you so much. This is the most thorough, concise & clear explanation of this frequent complication of the tear trough filling procedure that I have had the pleasure to view. It is by far one of the most complex areas in which to achieve natural correction, and takes years of experience to perfect. Your practitioner being “Board Certified” as a Plastic Surgeon, while excellent indication of anatomical expertise/safety/best practice does not guarantee that they have the skill & artistry to provide you with what you want. Always ask how many procedures of this specific type have they personally done? Ask to see multiple before and after pictures to get a feel for their work Decades of Knowledge,Skill in Medicine & Plastic Surgery (while hugely admirable & reassuring) does not guarantee that they are a master at every aspect of Facial Aesthetics and Tear Trough fillers are the most difficult of all to get right. I hope that this advice helps someone to get a beautiful result Much love RRx
Thank you so much for your kind words, RaeRae KC. I really appreciate them, and I'm really glad you connected with the video. You are absolutely right that experience, and expertise are more important than titles and certifications in achieving the best possible results. Thank you again.
Love how precisely you explained everything in this video! I got undereye fillers 3 days ago and am noticing the same kind of lumpiness. It's not as bad as it was 1 or 2 days ago, though. I've been told by 3 professionals until now that it is normal and will likely go away in about a few more days. Is that true in your opinion? (I don't have hollow cheeks). Other details: Neuremis Deep filler was used, 0.8 mls. My aesthetician wants to add 0.2 more of it as well as 0.4 mls of a fine filler, in another session after 7-10 days following the last session. She decided this based on the depth of my undereye hollowness. What would you suggest?
Hi ushna arif, Thank you for watching! I'm glad you found the video helpful. I hope you understand that I can't make specific treatment recommendations for you because I have not seen and examined your face. However, I do suggest you have a doctor administer filler because it is a safer procedure if the person doing it can react immediately to a medical emergency. You can refer to this video about the risks of under eye filler treatment, and how they can be avoided or minimized by an experienced doctor - ua-cam.com/video/lA6ietCvZf8/v-deo.html
Hi minky cat, Yes, it is safe, but like any treatment, safety depends on the experience and expertise of the injector. I did make a video about the safety of hyaluronidase, for your reference - ua-cam.com/video/a3YicyDoTZU/v-deo.html
It is the Restylane. My doctor used Restylane for my lips and under cheek bones. My lips didn't take. They did a little. Needless to say, I went back 3 times in a month and she added more in my lips and within 2 weeks it is gone again. My cheek bones, I had lumps, I went back, the first time for lips, and she dissolved filler in cheek bones. I googled it for days, finally found one other person that had the same problem. What her conclusion is that her body breaks down the filler so fast, 2 weeks for her as well, that it creates lumps or just goes away. That is the only answer I have come up with myself. It is now 2 months later and nothing has been in my lips for several weeks. You can't feel anything with your fingers.
Hi Lisa Starke, Sorry to hear about your problem. It is highly unlikely that you metabolized hyaluronic acid filler in two weeks. It is more likely due to placement technique with the filler migrating if it's placed too superficially; or even not enough filler material used, with initial results due more to temporary swelling than the filler material. You may want to try a different doctor as the viscosity of Restylane used in the under eye area is not appropriate for the cheekbones, as the cheeks should be treated with a thicker, longer lasting filler. You can refer to this video about avoiding lumps from cheek filler, and the advantages of having cheek filler placed at the bone level - ua-cam.com/video/cKotB7rhPEk/v-deo.html
Will it eventually be absorbed by my body naturally, because I honestly do not want go to the doctor I went to, and I don’t want to inject anything else on my face. It’s all very risky to me.
Hi Roseli Pestana, If you had a hyaluronic acid filler like Restylane or Juvederm administered, they are gradually metabolized. In a few cases where the filler is encapsulated which prevents metabolization, it does need dissolving with an injection treatment. I hope this clarifies things for you.
Hi sherry llfreeman, Injections do dissolve hyaluronic acid fillers are not considered surgery. If you did have a hyaluronic acid filler injected under your eyes, it will metabolize eventually on its own, and won't cost you extra. I hope this clarifies things for you.
I got some fillers done under my eyes and that I have that ledge effect cause i told the doctor no cheek fillers being that I didnt want all those foreign chemicals in my body what a big mistake
Hi Beloved Jordan, While I don't recommend foreign materials be placed into the body like semi-permanent and permanent fillers, which do cause foreign body reactions, hyaluronic acid does occur naturally in the body, so hyaluronic acid fillers are more safe and predictable. Hyaluronic acid fillers are safely metabolized by the body, which is why there volume is lost over time. The enzyme hyaluronidase that is used to dissolve fillers also occurs naturally in the body. You can are right about foreign materials causing issues, which I featured in this video about permanent and semi-permanent fillers - ua-cam.com/video/CZJ05rjav3s/v-deo.html
I have a question about sodium chloride being mixed with hylurondaise. Is sodium chloride the same thing as saline and is it the proper mixing solution for hylurondaise? Also if a surgeon puts some fat under my eye how will that affect wrinkles?
Hi Nicole Slighting, Sterilized saline would be the same as sodium chloride, but it's not used with hyaluronidase. Hyaluronidase is injected without being mixed with anything. I don't recommend fat grafts under thin lower eyelid skin. You can refer to these videos about it, and treatments for under eye wrinkles: ua-cam.com/video/mNo_EBcDi1k/v-deo.html ua-cam.com/video/PXMhY90TReM/v-deo.html
Excellent video!! Dr would you ever consider moonlighting here in Miami FL once a month? We need you here. I have at least 10 girlfriend's who need your expertise (myself included) lol. All the best in the new year.
One question Dr Prasad. If some of the tear trough filler should “drop” a little after 4 weeks, is it possible for a thicker filler to be placed on the cheek bone just beneath it to “lift/push it”back into place? I’m talking tiny aliquots here of course. Thank you RR
Hi RaeRae KC, I often use a more viscous hyaluronic acid filler at the eyelid-cheek junction in the upper cheek to act like a "shelf" to support filler in the lower eyelid. If the upper cheek is hollow or lost volume, treating the the lower eyelid is isolation is likely not enough for best results. I hope this clarifies things for you.
@@AmiyaPrasadMD Yes thank you- that confirms my thoughts. I had a lady consult who had TT filler done elsewhere. She had cheek filler at same time but still had a slight “drop” in the TT filler in one eye. She asked this question “Could I just add more cheek filler underneath to push it back” 😯and my reply on examination was that her cheek filler was inadequately firm to support the TT filler. I advised dissolving the tiny section of lumpy dropped TT filler if it really bothered her, and to use a more experienced practitioner once it needs to be redone. She was concerned about costs, so factoring that in, I felt that this was the best option for her at the present time. Thank you so much for your time & expertise in clarifying my thoughts & that decision Dr Prasad 🙏🏼
Hi bal Ma, We take questions on RealSelf.com, but you can also send your pictures through prasadcosmeticsurgery.com/virtual-consultation/ or eyelifts.com/virtual-consultation/ or puffyeyes.com/virtual-consultation/ for a preliminary review. Please note that this is not a formal consultation, but a preliminary evaluation. I hope to hear from you soon.
Where can I submit my photo? My eye has a deep hole right near the eye (it wasn’t injected enough) so I have these very white lumps now. I also have festoons on my cheeks.
Hi Miss Viking, We no longer feature submitted photos on videos, but you can send your pictures through prasadcosmeticsurgery.com/virtual-consultation/ but this is not a formal consultation. A formal, one-on-one Skype of Facelift video consultation with me can arranged through prasadcosmeticsurgery.com/skype-and-facetime-virtual-consultations/ I hope to hear from you soon.
Dr Prasad, if a patient has issues arising from doing under eye fillers and need to have use Hyalase, wouldn't it be hard to judge how much of the enzyme to use? I am thinking the enzyme would dissolve indiscriminately, and can end up dissolving too little or too much of the filler and this wouldn't solve the problem causing uneven results? So would doing a complete dissolution be the best? and start all over again on a 'blank' page? Thanks.
Oh ahaha you actually said that in the last bit of the video. If there is a need to do a complete dissolution, is this charged to patients, if it's done by the same doctor who does the original filler injection?
Hi, It depends on the individual doctor. If results look good, and not overdone, but the patient wants a different look, then they will be charged for new filler material, and reapplication. If the filler was not done correctly, then I can't speak for all doctors as to their individual policies. I'm conservative with my filler application at first, and add more if needed after two weeks to avoid overfilling. I hope this clarifies things for you.
Hi I m hanifa from london.i been through under eye filler injection.is been two months.but I got black circles under my eyes.i do apply ice and I apply tubes as well.but it did not work.doctor told me my skin is sensitive.so is gonna take Three months to recover.plz did he just console me or its reality.could u plz prescribe any madication which I can buy online from london.or plz u can give me any advice.i will keep waiting for ur kind ans.
Hi Hanifa Vaid, Sorry to hear about your problem. If you didn't have dark circles prior to the filler injection, then it was likely caused by the injection itself or your doctor's technique. I can't give you specific advice without physically examining your eye area, so I would defer to the advice of your doctor who has seen your condition, and knows the details of your skin type and how your filler treatment was. I hope this helps you.
Hi Dana Taylor, It seems like a good filler brand, although I haven't had the chance to use it in my practice. It's important to note that it's not the brand of the filler that's important, but the experience of the doctor using it, and their depth of placement especially in the cheeks that make all the difference in the results. Superficial placement in the cheeks is what leads to the pillowy, doughy look. I hope this clarifies things for you.
Hi I really loved all your answers seriously I wished if You will be my doctor 😔. I already wrote in realself but you did not answer about my question any way How can I write to you do you have email or something to share my problem with you?
Amiya Prasad, M.D. thanks Doc ! Yes PRP is amazing I had 3 Sessions they used the cannula for under the eyes so it was a little uncomfortable but it’s amazing
Dr Amiya knows exactly what I’m talking about.
He clearly would be an example of an excellent choice for this procedure as he has both a flawless understanding of the anatomy/physiology, and has an eye for artistic detail when it comes to a “natural result” and how to achieve this successfully.
Thank you again for your kind words, RaeRae KC!
I'm an Italian Doctor and I was looking for a clear explanation about some issuew with fillers: I must say that your explanation is great and I would love to be your patient if I would live in USA.
Thank you for your kind words, Bea Bea! And thank you for watching!
I live in Baltimore and saw him in the Virginia office for the same issue (w/Juvederm). That's after paying 2 other Docs and no resolution. I finally look normal again. #Thanks
You're welcome, Punanamous Me! Happy to have helped you!
Thank you so much.
This is the most thorough, concise & clear explanation of this frequent complication of the tear trough filling procedure that I have had the pleasure to view.
It is by far one of the most complex areas in which to achieve natural correction, and takes years of experience to perfect.
Your practitioner being “Board Certified” as a Plastic Surgeon, while excellent indication of anatomical expertise/safety/best practice does not guarantee that they have the skill & artistry to provide you with what you want.
Always ask how many procedures of this specific type have they personally done?
Ask to see multiple before and after pictures to get a feel for their work
Decades of Knowledge,Skill in Medicine & Plastic Surgery (while hugely admirable & reassuring) does not guarantee that they are a master at every aspect of Facial Aesthetics and Tear Trough fillers are the most difficult of all to get right.
I hope that this advice helps someone to get a beautiful result
Much love
RRx
Thank you so much for your kind words, RaeRae KC. I really appreciate them, and I'm really glad you connected with the video.
You are absolutely right that experience, and expertise are more important than titles and certifications in achieving the best possible results. Thank you again.
Love how precisely you explained everything in this video!
I got undereye fillers 3 days ago and am noticing the same kind of lumpiness. It's not as bad as it was 1 or 2 days ago, though. I've been told by 3 professionals until now that it is normal and will likely go away in about a few more days. Is that true in your opinion? (I don't have hollow cheeks).
Other details: Neuremis Deep filler was used, 0.8 mls. My aesthetician wants to add 0.2 more of it as well as 0.4 mls of a fine filler, in another session after 7-10 days following the last session. She decided this based on the depth of my undereye hollowness.
What would you suggest?
Hi ushna arif,
Thank you for watching! I'm glad you found the video helpful. I hope you understand that I can't make specific treatment recommendations for you because I have not seen and examined your face. However, I do suggest you have a doctor administer filler because it is a safer procedure if the person doing it can react immediately to a medical emergency. You can refer to this video about the risks of under eye filler treatment, and how they can be avoided or minimized by an experienced doctor - ua-cam.com/video/lA6ietCvZf8/v-deo.html
Is is safe to dissolve filler without destroying the native tissue? So much controversy.
Hi minky cat,
Yes, it is safe, but like any treatment, safety depends on the experience and expertise of the injector. I did make a video about the safety of hyaluronidase, for your reference - ua-cam.com/video/a3YicyDoTZU/v-deo.html
It is the Restylane. My doctor used Restylane for my lips and under cheek bones. My lips didn't take. They did a little. Needless to say, I went back 3 times in a month and she added more in my lips and within 2 weeks it is gone again. My cheek bones, I had lumps, I went back, the first time for lips, and she dissolved filler in cheek bones. I googled it for days, finally found one other person that had the same problem. What her conclusion is that her body breaks down the filler so fast, 2 weeks for her as well, that it creates lumps or just goes away. That is the only answer I have come up with myself. It is now 2 months later and nothing has been in my lips for several weeks. You can't feel anything with your fingers.
Hi Lisa Starke,
Sorry to hear about your problem. It is highly unlikely that you metabolized hyaluronic acid filler in two weeks. It is more likely due to placement technique with the filler migrating if it's placed too superficially; or even not enough filler material used, with initial results due more to temporary swelling than the filler material. You may want to try a different doctor as the viscosity of Restylane used in the under eye area is not appropriate for the cheekbones, as the cheeks should be treated with a thicker, longer lasting filler. You can refer to this video about avoiding lumps from cheek filler, and the advantages of having cheek filler placed at the bone level - ua-cam.com/video/cKotB7rhPEk/v-deo.html
Useful content. Thanks doc.
You're welcome, Shadow UA-cam ! Thanks again for watching!
Will it eventually be absorbed by my body naturally, because I honestly do not want go to the doctor I went to, and I don’t want to inject anything else on my face. It’s all very risky to me.
Hi Roseli Pestana,
If you had a hyaluronic acid filler like Restylane or Juvederm administered, they are gradually metabolized. In a few cases where the filler is encapsulated which prevents metabolization, it does need dissolving with an injection treatment. I hope this clarifies things for you.
canu get rid of a under eye filler with out getting injection because I cant afford surgery
Hi sherry llfreeman,
Injections do dissolve hyaluronic acid fillers are not considered surgery. If you did have a hyaluronic acid filler injected under your eyes, it will metabolize eventually on its own, and won't cost you extra. I hope this clarifies things for you.
I got some fillers done under my eyes and that I have that ledge effect cause i told the doctor no cheek fillers being that I didnt want all those foreign chemicals in my body what a big mistake
Hi Beloved Jordan,
While I don't recommend foreign materials be placed into the body like semi-permanent and permanent fillers, which do cause foreign body reactions, hyaluronic acid does occur naturally in the body, so hyaluronic acid fillers are more safe and predictable. Hyaluronic acid fillers are safely metabolized by the body, which is why there volume is lost over time. The enzyme hyaluronidase that is used to dissolve fillers also occurs naturally in the body. You can are right about foreign materials causing issues, which I featured in this video about permanent and semi-permanent fillers - ua-cam.com/video/CZJ05rjav3s/v-deo.html
Really helpful.
Glad the video helped you, Lorraine Bowie!
I have a question about sodium chloride being mixed with hylurondaise. Is sodium chloride the same thing as saline and is it the proper mixing solution for hylurondaise? Also if a surgeon puts some fat under my eye how will that affect wrinkles?
Hi Nicole Slighting,
Sterilized saline would be the same as sodium chloride, but it's not used with hyaluronidase. Hyaluronidase is injected without being mixed with anything.
I don't recommend fat grafts under thin lower eyelid skin. You can refer to these videos about it, and treatments for under eye wrinkles:
ua-cam.com/video/mNo_EBcDi1k/v-deo.html
ua-cam.com/video/PXMhY90TReM/v-deo.html
Excellent video!! Dr would you ever consider moonlighting here in Miami FL once a month? We need you here. I have at least 10 girlfriend's who need your expertise (myself included) lol.
All the best in the new year.
Happy New Year, NIKKI STAHR! I'm already busy with our 3 locations in New York and Virginia, but you and your friends can come see us here!
One question Dr Prasad.
If some of the tear trough filler should “drop” a little after 4 weeks, is it possible for a thicker filler to be placed on the cheek bone just beneath it to “lift/push it”back into place?
I’m talking tiny aliquots here of course.
Thank you
RR
Hi RaeRae KC,
I often use a more viscous hyaluronic acid filler at the eyelid-cheek junction in the upper cheek to act like a "shelf" to support filler in the lower eyelid. If the upper cheek is hollow or lost volume, treating the the lower eyelid is isolation is likely not enough for best results. I hope this clarifies things for you.
@@AmiyaPrasadMD Yes thank you- that confirms my thoughts.
I had a lady consult who had TT filler done elsewhere.
She had cheek filler at same time but still had a slight “drop” in the TT filler in one eye.
She asked this question “Could I just add more cheek filler underneath to push it back” 😯and my reply on examination was that her cheek filler was inadequately firm to support the TT filler.
I advised dissolving the tiny section of lumpy dropped TT filler if it really bothered her, and to use a more experienced practitioner once it needs to be redone.
She was concerned about costs, so factoring that in, I felt that this was the best option for her at the present time.
Thank you so much for your time & expertise in clarifying my thoughts & that decision Dr Prasad 🙏🏼
You're welcome,@@DrMattiLabbratt
Dr. Prasad, how do i submit questions to you? Thank you
Hi bal Ma,
We take questions on RealSelf.com, but you can also send your pictures through prasadcosmeticsurgery.com/virtual-consultation/ or eyelifts.com/virtual-consultation/ or puffyeyes.com/virtual-consultation/ for a preliminary review. Please note that this is not a formal consultation, but a preliminary evaluation. I hope to hear from you soon.
Where can I submit my photo? My eye has a deep hole right near the eye (it wasn’t injected enough) so I have these very white lumps now. I also have festoons on my cheeks.
Hi Miss Viking,
We no longer feature submitted photos on videos, but you can send your pictures through prasadcosmeticsurgery.com/virtual-consultation/ but this is not a formal consultation. A formal, one-on-one Skype of Facelift video consultation with me can arranged through prasadcosmeticsurgery.com/skype-and-facetime-virtual-consultations/ I hope to hear from you soon.
Dr Prasad, if a patient has issues arising from doing under eye fillers and need to have use Hyalase, wouldn't it be hard to judge how much of the enzyme to use? I am thinking the enzyme would dissolve indiscriminately, and can end up dissolving too little or too much of the filler and this wouldn't solve the problem causing uneven results? So would doing a complete dissolution be the best? and start all over again on a 'blank' page? Thanks.
Oh ahaha you actually said that in the last bit of the video. If there is a need to do a complete dissolution, is this charged to patients, if it's done by the same doctor who does the original filler injection?
Hi,
It depends on the individual doctor. If results look good, and not overdone, but the patient wants a different look, then they will be charged for new filler material, and reapplication. If the filler was not done correctly, then I can't speak for all doctors as to their individual policies. I'm conservative with my filler application at first, and add more if needed after two weeks to avoid overfilling. I hope this clarifies things for you.
@@AmiyaPrasadMD Thanks 😊
You're welcome!
Really good
Thank you, Saeed Gavahi! Glad you liked the video!
Hi I m hanifa from london.i been through under eye filler injection.is been two months.but I got black circles under my eyes.i do apply ice and I apply tubes as well.but it did not work.doctor told me my skin is sensitive.so is gonna take Three months to recover.plz did he just console me or its reality.could u plz prescribe any madication which I can buy online from london.or plz u can give me any advice.i will keep waiting for ur kind ans.
Hi Hanifa Vaid,
Sorry to hear about your problem. If you didn't have dark circles prior to the filler injection, then it was likely caused by the injection itself or your doctor's technique. I can't give you specific advice without physically examining your eye area, so I would defer to the advice of your doctor who has seen your condition, and knows the details of your skin type and how your filler treatment was. I hope this helps you.
What do you think about Teosyal RHA? For the cheeks.
Hi Dana Taylor,
It seems like a good filler brand, although I haven't had the chance to use it in my practice. It's important to note that it's not the brand of the filler that's important, but the experience of the doctor using it, and their depth of placement especially in the cheeks that make all the difference in the results. Superficial placement in the cheeks is what leads to the pillowy, doughy look. I hope this clarifies things for you.
Thank you.
You're welcome,@@1whitecottagelife770!
Hi I really loved all your answers seriously I wished if You will be my doctor 😔. I already wrote in realself but you did not answer about my question any way How can I write to you do you have email or something to share my problem with you?
Hi rasha jawad,
What's your question?
This happened to me I was so upset paid about $600 and we had to dissolve it and I had PRP done to the eye area instead
Sorry to hear that, ima believer. It's very important to go with a skilled doctor for filler treatment. I hope PRP alone worked out well for you.
Amiya Prasad, M.D. thanks Doc !
Yes PRP is amazing I had 3
Sessions they used the cannula for under the eyes so it was a little uncomfortable but it’s amazing
Happy to hear that, @@mrknight7957!