Facial fillers help restore volume to the face but injectors who perform them should understand the subtleties of anatomy and aesthetics. Dr. Iyengar is the most experienced oculoplastic surgeon in the community when it comes to the use of tear trough rejuvenation with facial filler. He is regularly consulted for this by other excellent injectors such as dermatologists and nurse injectors. In 2020, we find the use of a cannula significantly reduces the risk of bruising and as such Dr. Iyengar employs a painless blunt cannula delivery of filler in the tear trough area.
Dr. Iyengar is frequently asked to fix complications for facial filler. This is a patient that had multiple vials of filler placed in her lower eyelid by a plastic surgeon in Carmel Valley. Once her filler had been dissolved, she was referred to a dermatologist for laser tightening of the skin.
Fillers around the eye are best placed by an oculoplastic surgeon. Recent literature from UC San Francisco recently demonstrated a case where a patient ended up with tearing because filler was inadvertently placed within the tear drainage system, which is located in the lower eyelid. This is an area that only oculoplastic surgeons work with. Fortunately, this was fixed by the use of hyaluronidase.
Kalin-Hajdu, E, Kersten RC. Nasolacrimal duct obstruction following hyaluronic acid rejuvenation of the tear trough. Ophthalmic Plastic and Reconstructive Surgery 2019
Restylane is one of the fillers that Dr. Iyengar uses to rejuvenate the tear trough in patients who are not ready for surgery or would not benefit from surgery. As San Diego’s expert in lower eyelid fillers, Dr. Iyengar employs a conservative natural-looking approach that is appreciated by his physician peers. This is an eye doctor who came to see Dr. Iyengar for tear trough rejuvenation but was not ready for eyelid surgery. She required one syringe of Restylane.
This is a kind doctor that came to see Dr. Iyengar for hollowness in the tear troughs. This Before and after case highlights the use of an injectable to fix the tear trough.