A: Restylane is an excellent option for filling in under-eye hollows, but it must be injected deeply and conservatively to prevent the clear HA gel from showing through the thin skin in this location, resulting in the blue tinge called the Tyndall effect. Laser is not necessary. A quick, tiny nick into the skin and a Q Tip to milk it out is best. The other option is to dissolve it with Vitrase. The Q switched YAG laser, which gets the blue color, is very risky so close to the eye.
Q: Is there any new news about Restylane? It has been around a while but I have never done filler.
A: Restylane was the first hyaluronic acid filler to gain FDA approval back in 2003 for nasolabial folds. It has recently been in the news because it is now the first FDA approved filler for lip augmentation. Restylane is also the preferred filler for under-eye filling to improve the hollowed area under the eyes that make you look tired.
Q: I have wrinkled skin on my chest from years of sunbathing and indoor tanning (what a mistake!). What are my options to have my chest look younger?
A: I used a combination approach to the aging chest. First, daily UV protection with a sunscreen and antioxidant (like Revale) protect from further damage. At night, I recommend retinoids and peptides to heal the damaged collagen. Some kind of laser/light device is needed. I usually do Fraxel Dual, IPL, or for severe cases, Active FX CO2 laser. Lastly, injectables may be of benefit in some patients. Tiny amounts of Botox have been used, but I prefer Restylane, which I dilute with saline to prevent lumping in this thin-skinned area. Finally, sleep on your back. Side sleeping accentuates those wrinkles, especially if you are large-busted.
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