Treating Under Eye Hollows with Fillers or Implants, and Why Fat Grafting Isn't Advised
Рет қаралды 28,901
Күн бұрынMore on under eye fillers: prasadcosmeticsurgery.com/und...
For more on tear trough implants, please go to: prasadcosmeticsurgery.com/tea...
More on fat grafting/ fat transfer, please go to: prasadcosmeticsurgery.com/med...
For more about Dr. Prasad's background and training, please go to:
prasadcosmeticsurgery.com/dr-...
New York oculoplastic and reconstructive surgeon Amiya Prasad, M.D. talks about the causes of under eye hollowing, the different treatments available, and which method can most effectively address this concern
0:21 - Introduction to factors that cause under eye hollowing
0:42 - Dr. Prasad details his background training in cosmetic oculofacial plastic and reconstructive surgery, as well as his experience as an eyelid rejuvenation specialist
1:20 - Addressing under eye hollowing with tear trough implants
1:56 - How facial aging occurs at the bone level of the face
2:20 - Dangers of fat grafting as a solution for under eye hollowing
2:57 - Dangers of semi-permanent fillers as a solution for under eye hollowing
3:48 - Why Dr. Prasad prefers to use hyaluronic acid fillers for facial volume correction
4:00 - How Dr. Prasad administers fillers for volume correction
4:15 - Advantages of using softer hyaluronic acid fillers
5:18 - The role of PRP in addressing crepey, sun-damaged skin
5:47 - How full results from filler can be seen after 2 weeks
6:08 - Why there are no permanent cosmetic treatments, as the body is constantly changing
6:25 - Conclusion and Dr. Prasad’s recommendation
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@bartbollen8166 3 жыл бұрын
Love how you speak so clearly and slowly so your listeners can take in and process what you are telling us. Wish you were in Australia Dr Prasad.
@AmiyaPrasadMD 3 жыл бұрын
Thank you so much for your kind words, Bart Bollen! I'm glad you found the video helpful!
@tiaedwards3587 3 жыл бұрын
He would have been a great teacher the way he speaks so calmly
@AmiyaPrasadMD 3 жыл бұрын
Thank you for the compliment, @@tiaedwards3587!
@KH-bk8xs 5 жыл бұрын
You are an excellent educator, specialist and reassuring! Thank You Again!
@AmiyaPrasadMD 5 жыл бұрын
Thank you for your kinds words, K H!
@gaylekemper3616 5 жыл бұрын
I really enjoy your honest and truthful answers to these questions.
@AmiyaPrasadMD 5 жыл бұрын
Thank again, Gayle Kemper! Glad you find the videos helpful!
@marianthipapastergiadis7744 4 жыл бұрын
could you please make a video specifically about under eye wrinkles? for example, what is the best treatment? laser? filler? botox? I keep reading so much contradictory information and I trust you as an expert in this area!
@AmiyaPrasadMD 4 жыл бұрын
Hi maz p, I already did! :) I think this should answer all your questions - kzfaq.info/get/bejne/hr59m7xqlbq2lYE.html
@Kate-ps3dm 4 жыл бұрын
Dr. Prasad, Thank you for this enlightening video. One thing I wish Plastic Surgeons discussed more often is the idea of injection longevity and migration over time. I am not sure on the extent of research in this (filler) area, however it’s been displayed by multiple doctors-usually through MRI-that these fillers are still present or migrated quite long after they were supposed to have “dissolved.” That being said, it’s now a major drawback in my consideration of fillers. Do you have any advise for this?
@AmiyaPrasadMD 4 жыл бұрын
Hi Kate Leone, It's important to have fillers done, especially in the under eye area, by experienced doctors, and to stick with reputable hyaluronic acid fillers. I have made several videos about considerations of dissolution and reversal you can refer to: kzfaq.info/get/bejne/jcCAfamnmLnHo30.html kzfaq.info/get/bejne/b7ePn9t-0p3TnKc.html kzfaq.info/get/bejne/l5mJnMaqqdW4iok.html
@bubbamell50 Жыл бұрын
I have terrible under eye bags and somewhat deep tear troughs and seriously considering a filler. I look tired and sometimes they’re puffier than others. I had my upper lids done last April and I’m very pleased and I need a balance, just want to do my research. The surgeon that did my lids is an occuloplastic surgeon and will do my lower lids but I’m a bit nervous about it. Besides my insurance covered the surgery but of course won’t cover the lower lids. I love your videos and too bad I’m not closer to your office otherwise I’d see you. Thanks for being so informative. I did mention to you last year about my surgery and you responded. Thank you!
@AmiyaPrasadMD Жыл бұрын
Hi @@bubbamell50, You're welcome. I suggest you ask for transconjunctival blepharoplasty by name, which involves no external incision in the lower eyelid for visible scarring and potential damage to lower eyelid support structures; and insist on no lower eyelid skin removal to treat wrinkles, as this can cause skin shortage that will pull down the lower eyelids. Under eye wrinkles can be treated non-surgically to improve skin quality. You can refer to this video about it - kzfaq.info/get/bejne/apx7o5mS3szdqps.html
@user-wk2ei3qg8e 2 жыл бұрын
Very informative, thank you!
@AmiyaPrasadMD 2 жыл бұрын
You're welcome, D. I'm glad you found the video informative. Many people say they wish they saw this video before having complications from fat grafting in the lower eyelids.
@shadenmohammed6242 4 жыл бұрын
Thank you doctor. That was sooooo helpful😊
@AmiyaPrasadMD 4 жыл бұрын
You're welcome, Shaden Mohammed! Glad you found the video helpful!
@bombasticbushkin4985 4 жыл бұрын
Thank you Dr Prasad. Your information and time is priceless. You are an amazing man. All the best.
@AmiyaPrasadMD 4 жыл бұрын
You're welcome, Bombastic Bushkin! Glad you found the video helpful!
@nycsp 4 жыл бұрын
Awesome video !!!! Thank you !!
@AmiyaPrasadMD 4 жыл бұрын
You're welcome, nycsp! Glad you found the video helpful!
@e_the_real 3 жыл бұрын
Hello ! Thank you for the informative videos. One thing, why don't you never mention the fillers migrating to other parts of the face ? (Even if we can dissolve it, it still migrates regardless of how well the procedure has been executed). I have hereditary hollow eyes, dark under eyes and I don't see myself injecting fillers every 5 months for the rest of my life, looks like too much filler in my face....
@AmiyaPrasadMD 3 жыл бұрын
Hi ELIZABETH, Glad you find the videos informative! I actually do have videos that feature filler migration, but these are more about cheek filler migration. If under eye fillers do actually migrate, they don't move far from their original location, and it's not a lot of filler material under the eyes because this space can only hold so much, and the eyelid-cheek junction can also be filled for volume and support if it also lacks projection as a "shelf" for under eye filler. You can refer to these videos about how I prevent migration of cheek fillers, which is the most problematic and visibly obvious: kzfaq.info/get/bejne/eNiSZ9iF3-CraGw.html kzfaq.info/get/bejne/eb2Yp6l5u8_Kl58.html
@johnnysatty 5 жыл бұрын
What is your take on new products like renuva
@gaylekemper3616 5 жыл бұрын
I believe you more then others you know what your talking about.
@AmiyaPrasadMD 5 жыл бұрын
Thank you, Gayle Kemper! There are a lot of good doctors out there, but I just want to clear some misconceptions so people make good decisions about cosmetic procedures, and get them done safely.
@muhammadusman2054 5 жыл бұрын
How can we submit a question? ?
@kristinahill2641 Жыл бұрын
luv your videos.
@AmiyaPrasadMD Жыл бұрын
Thank you, Kristina Hill. I hope the videos are helping you. Thanks for watching!
@auroragiattino3374 3 жыл бұрын
So well spoken, such a great video! Thanks Doc. Appreciate how thorough you are. I have a few questions for you: How long on average do the results of PRP last in terms of its under eye effects? How safe is it to repeat? Do people ever get PRP and then under eye fillers, or rotate? Is it that sort of thing? If yes, how much time in between? Would facial laser hair removal be ok ontop of these therapies once administered?
@AmiyaPrasadMD 3 жыл бұрын
Hi Aurora Giattino, PRP under the eyes improves overall skin health and quality, so it doesn't fade, but improvement can be built upon with succeeding treatments, and PRP doesn't stop the effects of aging. PRP is safe to repeat, and frequency depends on the issue being treated. PRP does improve the fat layer beneath the skin, and does provide some volume, but it cannot replace a filler. Laser hair removal can be done after PRP treatment. I hope this clarifies things for you.
@fenrizia6068 Жыл бұрын
@@AmiyaPrasadMD Following up on your answer to Aurora's question, I was wondering if it's possible to use PRP to improve skin quality and build up some fat volume in the under eye area, before trying tear trough filler, in order to make the filler injections safer? I would like to get tear trough filler, but my practitioner says she doesn't want to risk it, because I have really thin skin in that area, and no fat. Do you think there's any chance that PRP treatments might solve my problem? Thank you in advance!
@AmiyaPrasadMD Жыл бұрын
Hi@@fenrizia6068, While PRP can thicken thinned lower eyelid skin, it is not going to build up fat volume in the lower eyelid. Eyelid skin is naturally the thinnest skin in the body at 0.5mm thick, and many doctors just aren't experienced in injecting in the delicate eye area. I suggest you see a doctor who injects the eye area routinely (like myself) for a second opinion if tear trough filler is appropriate for your case. I hope this clarifies things for you.
@fenrizia6068 Жыл бұрын
@@AmiyaPrasadMD Thank you for your answer! I may have used the wrong words, but I was referring to what you wrote to Aurora about PRP improving the fat layer beneath the skin, and providing some volume (I know it won't create volume in the same way that filler can). What I really wanted to know was whether, in theory, PRP could make someone a better candidate for tear trough filler, if they are not such a good candidate to begin with, due to poor skin quality. Also, I live in Europe, so unfortunately I can't come see you for a consultation, but I could definitely try to get a second opinion from someone else that might be more experienced than my current practitioner.
@AmiyaPrasadMD Жыл бұрын
Hi@@fenrizia6068, The lower eyelids don't have the essential fat layer behind the skin. It's not clear if you are not a candidate for under eye filler because of your skin quality, of if your practitioner just doesn't inject in the eye area. Like I said previously, PRP can increase thickness of your eyelid skin, and improve skin quality. I hope this clarifies things for you.
@Preeti_5911 2 жыл бұрын
Thanks Dr... I ws about to go for fat grafting bt now i ll go for reversible filler
@AmiyaPrasadMD 2 жыл бұрын
I'm glad you found the video before deciding on fat grafting, preeti sahare!
@TheMijas07 3 жыл бұрын
Hi Dr. Prasad, new subscriber here. Love love your videos and how you speak and clearly explain everything. One question: in the cosmetic industry last couple of years, more doctors are promoting PRF (platelet rich fibrin) saying that PRP does not last as well and we've moved on to something better. It is using some of the blood in with the plasma (from what I can gather). What is your opinion on this? Have you seen the results (or heard of them) and do you think it is better? Both are similar procedures just a slight difference in the composition of the plasma. Thanks!
@AmiyaPrasadMD 3 жыл бұрын
Hi Val O, I've been administering PRP and PRFM for a lot longer than most in cosmetic medicine, and was talking about it on video while other doctors were still saying they weren't effective. PRP and PRFM are actually almost the same thing. PRFM is PRP with added calcium chloride to make it a thick gel for slow release of the healing and growth factors. The thing with PRP is that improves the skin health and quality, so its effects last, and it's not like a filler which loses volume over time. For most cases of skin quality improvement, PRP works well, and I usually don't see a significant added benefit for making it into PRFM. I hope this clarifies things for you.
@TheMijas07 3 жыл бұрын
@@AmiyaPrasadMD Thanks so much for that explanation :-)
@AmiyaPrasadMD 3 жыл бұрын
You're welcome, @@TheMijas07!
@shangrila628 3 жыл бұрын
Thanks Dr! Is there any utility for lower bleph in someone in their 30's with genetic hollowness under the eyes? Is bleph only useful for "fatty bulge" and not hollowness? Is filler my only choice?
@AmiyaPrasadMD 3 жыл бұрын
Hi shangrila628, You can refer to these videos about eye bags can make the adjacent area appear hollow; and how a person can have eye bags treated, but have hollowness in the upper cheeks: kzfaq.info/get/bejne/h5aBnLF5nLK5hn0.html kzfaq.info/get/bejne/apx7o5mS3szdqps.html
@gillyfranklin1550 4 жыл бұрын
Thank you for this video - my problem is that my orbital rim is quite low so hyaluronic acid filler has not been very successful at treating the hollowness. Would orbital rim/tear trough implants be a viable option in a case like mine?
@AmiyaPrasadMD 4 жыл бұрын
Hi Gilly Franklin, You may need filler in the upper cheek to comprehensively treat hollowness. You can see the results of this approach in these videos: kzfaq.info/get/bejne/eZegq9KGnMuVg3k.html kzfaq.info/get/bejne/h5aBnLF5nLK5hn0.html kzfaq.info/get/bejne/apx7o5mS3szdqps.html
@deepthin3824 2 жыл бұрын
Is Blepharoplasty a good idea for tear-troughs/ hollow eyes? If so how long would the results last??
@AmiyaPrasadMD 2 жыл бұрын
Hi Deepthi N, In some cases when the puffiness makes the adjacent area look relatively hollow. You can refer to this video about it, as well as this other video about how long lower eyelid surgery lasts: kzfaq.info/get/bejne/h5aBnLF5nLK5hn0.html kzfaq.info/get/bejne/kMB-psWcvc2vh5s.html
@jm7858 2 жыл бұрын
When placing fillers in the undereye tear trough area in what layer do you inject them? Superficially or on top of the bone?
@AmiyaPrasadMD 2 жыл бұрын
Hi Jamie Mills, The tear trough is a shallower area compared to other areas of the face, so the filler is placed right on top of the bone without penetrating very deeply. I hope this clarifies things for you.
@DrAdnan 5 жыл бұрын
Is there much bone change or is aging more a function of fat and skin?
@AmiyaPrasadMD 5 жыл бұрын
Hi Adnan A, Bone loss is the most significant in volume loss due aging, although volume loss also includes loss of muscle, soft tissue, and fat. I hope this clarifies things for you.
@CyrusOmerta 4 ай бұрын
What about migrating issues with filler and the fact that filler sticks around longer than we initally thought? The victorian cosmetic institute did a great vid on this. What are your thoughts?
@AmiyaPrasadMD 4 ай бұрын
Hi @CyrusOmerta, You can refer to these videos the causes, and prevention of filler migration; as well as advanced dissolving of hyaluronic acid filler: kzfaq.info/get/bejne/o9eCpteTscnHf2g.html kzfaq.info/get/bejne/Y96Vo7d3vZ6XfJc.html kzfaq.info/get/bejne/hpiRZZZ7rtjKZqs.html
@katiemiller2803 2 жыл бұрын
Does Sculptra in the cheeks reduce dark circles/hollowness? I have seen several Sculptra before/after pics, and the dark circles are greatly reduced (though I know one cannot use Sculptra in the eye area). I like that Sculptra encourages your own collagen production, and is itself gone in 2 weeks after injection. I am afraid of Hyaluronic Acid becoming puffy/pillow face down the road (and heard of lots of unhappy ladies who have gotten HA tear trough fillers).
@AmiyaPrasadMD 2 жыл бұрын
Hi Katie Miller, Filling under the eyes for hollowness requires more precision than is possible with Sculptra. The results of Sculptra are unpredictable because it is your own body generating volume, so it's not something that can be fully controlled. The results of under eye filler are determined by the skill of the doctor performing the treatment, not by the filler material, like a sculpture is determined by the sculptor, not by the clay. While a pillowy appearance is definitely a concern when performing facial filler treatment, I made a video showing how it can be avoided completely with deeper filler placement, for your reference - kzfaq.info/get/bejne/eNiSZ9iF3-CraGw.html
@yadhamin 5 жыл бұрын
Hello doctor, i know this comment is not related to the video but i wanted to ask. I am 20. I've been using minoxidil shampoo for 3 weeks or so and i am using it once a day, but my hair loss is increasing compare to before. Should i keep using it or not. Thanks for answering...
@AmiyaPrasadMD 5 жыл бұрын
Hi Yad H Amin, Minoxidil won't thicken your hair, or stop hair loss, but it appears to delay the hair shedding cycle, and extends the hair growth cycle so you appear to have more hair on your head. You will have to use it daily to sustain these effects, but these effects can also decrease with time even if you use it daily. I do think finasteride is more beneficial than minoxidil as it can slow down and stabilize hair thinning, and it can be used long-term more predictably. If you want to stimulate hair growth and thicken thinning hair, look into the Hair Regeneration treatment featured in my other videos, like this one about the importance of finasteride for men your age - kzfaq.info/get/bejne/nLKDdZClqpbLk6M.html
@PoojaMishra-xp5ln 5 жыл бұрын
Hi Dr Amiya, Dermal fillers used for acne scars are said to last only for about 6 months to 1 year, After which the treatment will have to be redone to maintain the result. Are acne scars for life? I'll have to continue getting the fillers done every one year for life long?
@AmiyaPrasadMD 5 жыл бұрын
Hi Pooja Mishra, Yes, hyaluronic acid fillers do need maintenance, but they are the safest filler. Deep acne scars are often for life as they involve permanent tissue loss. There are permanent and semi-permanent fillers, but these are not safe as they can't be metabolized, are difficult to remove if there are complications, and the longer they are in the body, the higher the chance of complications like infection and foreign body reactions. On the other hand, hyaluronic acid is naturally present in the body, and they are metabolized safely by the body, which is why they last for about a year. I hope this clarifies things for you.
@MC-pg2ko 3 ай бұрын
I have 'live grafts' (tissue harvested from my lower back fat) and grafted in my lower eye (a procedure invented by Dr Meronk). The surgeon who perform this was a reconstructive plastic surgeon in Lithuania. He clearly did not have experience with this procedure and I regret that I haad it done as my eyes have never looked worse. I now don't know if the grafts can be taken out as they look resemble fat pockets and if this will result in eye hollowing. I am seriously considering implants as even with ageing and their visibility, it has to be better than my present "look".
@AmiyaPrasadMD 3 ай бұрын
Hi @MC-pg2ko, Sorry to hear about your problem. The fact remains that once fat is removed from its original blood supply, its shape and texture are inconsistent and unpredictable once it takes to a new blood supply, or tries to take to a new blood supply. These grafted fat irregularities can be more easily seen through very thin lower eyelid skin, which is the thinnest skin in the body. If you'd like our help with your situation, and can come in for your corrective procedures, please let us know.
@hafsakhan355 5 жыл бұрын
Hello dr! My skin is oily and I have been suffering from a lot of pimples since 2017 and I never pick them but they get accidently scratched when I wash my face for apply moisturizer but they haven't scared yet...what procedure is best to prevent scars? Thanks in advance!
@AmiyaPrasadMD 5 жыл бұрын
Hi Hafsa Khan, Acne scars happen due to tissue loss, which is unclear if it happened to you without examining your skin. You can refer to this video about the different treatments for acne scars - kzfaq.info/get/bejne/Z6d5hbSTrtu0ooE.html
@sarahm9723 2 жыл бұрын
Great video! Thanks! Question: How do you deal with the migration of hyaluronic acid filler to other parts of the face?
@AmiyaPrasadMD 2 жыл бұрын
You're welcome, Sarah M! The amount of filler material used in the lower eyelids is minimal, and what usually causes migration is more filler being placed than the skin and soft tissue can hold. While I do apply more substantial, and thicker fillers in areas like the cheeks at the bone level, and held by the muscle layer to prevent migration; using a less viscous, small filler behind the eyelid skin usually doesn't migrate, and if it does, it doesn't move far from the original location. I hope this clarifies things for you.
@sarahm9723 2 жыл бұрын
@@AmiyaPrasadMD Yes, thank you!
@AmiyaPrasadMD 2 жыл бұрын
You're welcome,@@sarahm9723!
@sumanthgowda8313 3 жыл бұрын
Hey doc, how long does derma fillers lasts?
@AmiyaPrasadMD 3 жыл бұрын
Hi Sumanth Gowda, Softer hyaluronic acid fillers for the under eye area last about a year. Hyaluronic acid is the safest filler material as it naturally exists in the body, and the longevity depends on the thickness. You can refer to this video about the longevity of cosmetic fillers - kzfaq.info/get/bejne/b7ePn9t-0p3TnKc.html
@user-yq6uu1pi6r 2 жыл бұрын
I watched a video by a different plastic surgeon and he says he does not use hyaluronic fillers because they can cause water retention and swelling years later.
@AmiyaPrasadMD 2 жыл бұрын
Hi Gabrielle Gilbert, The function of the body's natural hyaluronic acid is to retain moisture. However, depending on the viscosity of a hyaluronic acid filler, they only last 6 months to 2 years, and can be dissolved at any time by an experienced injector. Sometimes when filler gets encapsulated, they can last longer than their expected longevity, but in these cases they can also be safely dissolved. You can refer to this new video about safely dissolving filler, even when it is placed deep - kzfaq.info/get/bejne/Y96Vo7d3vZ6XfJc.html
@kazballa24 2 жыл бұрын
Hi Dr Prasad, I had RHA 2 injected in the under eye, is this a reputable HA filler?
@AmiyaPrasadMD 2 жыл бұрын
Hi Kaz B, While I don't use that particular filler in my practice, it is a reputable filler. Keep in mind that results are determined by your doctor more than the filler material. You can refer to this video about it - kzfaq.info/get/bejne/nN2EdaaarK21o2g.html
@o56_idress_ahmed_ee32 5 жыл бұрын
if one takes finasteride during an early onset of baldness,and he continues it for 10 years.will he delay the baldness for that time.let us say he takes at 20 and stops at 30..if he had not taken finasteride he would have been bald at 40.my question is will the person get bald by 50 after quitting at 30 as he had delayed 10 years...
@AmiyaPrasadMD 5 жыл бұрын
If you have male pattern hair loss in your 20s,meaning a high-level of DHT-sensitivity, and don't take finasteride, you will get bald faster. If you stop taking it, DHT blocking stops, and your hair will thin again. If you want to do something about your hair loss, you have to act now.
@carlitacabrera5845 2 жыл бұрын
Doc, so if i would like to elevate my lower eye lid a 1mm with fat crafting ( as in many articles state mid face lift is the solution for this) fat crafting wont work? It would leave the área lumpy and so....? Thank you doc
@AmiyaPrasadMD 2 жыл бұрын
Hi Carlita Cabrera, Fat grafting behind thin lower eyelid skin is always prone to complications due to the lumpiness, and unpredictability of grafted fat. As an oculoplastic surgeon, I perform different procedures to raise the lower eyelids without fat grafting. You can refer to this video about it - kzfaq.info/get/bejne/jK9kjZOjqbWZc2w.html
@ImpulseOO 3 жыл бұрын
Thank you for this great video Dr Prasad! What about the midface lifting (i.e. with endotines), can it help with under eye hollowness?
@AmiyaPrasadMD 3 жыл бұрын
Hi Andrey Zhigalov, A midface lift is for lifting lax skin, soft tissue, and the underlying facial muscle. Under eye hollowness is a completely separate issue of lacking fat volume under the eyes, so it's not treated by a midface lift. I hope this clarifies things for you.
@bindokboys 2 жыл бұрын
Hello Doctor, how to find out if you need blepheroplasty or you should go for fillers?
@AmiyaPrasadMD 2 жыл бұрын
Hi Abhijit P, That determination is done by an experienced doctor who can do both procedures. If a doctor who isn't a surgeon can't perform lower eyelid surgery, they may recommend filler regardless, so it's best to see an experienced surgeon for advice without bias. I hope this clarifies things for you.
@reimarina494 3 жыл бұрын
What about the shifting/migrating of HA filler? Does this occur in the undereye area? :o
@AmiyaPrasadMD 3 жыл бұрын
Hi Rei Marina, In my extensive clinical experience, I haven't had hyaluronic acid filler placed in the lower eyelid or tear trough migrate in my patients, although it is possible depending the doctor's technique in performing this treatment. Generally speaking, filler does not migrate far from the original location where it was placed. I hope this clarifies things for you.
@TheYvib Жыл бұрын
I also think that hyaluronic acid filler is the best choice but what about the risk of going blind?
@AmiyaPrasadMD Жыл бұрын
Hi TheYvib, The risks of under eye fillers are avoided or minimized by the experience of the doctor performing the treatment. You can refer to this more recent video about it - kzfaq.info/get/bejne/oqdmnMilqNy-lmw.html
@mrsoupYt 4 жыл бұрын
Hi, doc. Can i have laser treatment after having prp
@AmiyaPrasadMD 4 жыл бұрын
Hi siew ha soo, I often alternate PRP and laser treatment, or do them both together. However, I would have to see your skin first to see if laser is appropriate for issue, skin color, and skin type. I hope this clarifies things for you.
@medicinatips3197 3 жыл бұрын
Hi doctor, if the fat graft is placed on the cheek area and not under the eye to dissimulated dark circles, is it safe? Or does it have the same complications as if it was placed under the eyes. Than you
@AmiyaPrasadMD 3 жыл бұрын
Hi medicinatips, Fat grafting is safer under thicker skin, but it is still unpredictable as fat can be quickly absorbed by the body, especially if it doesn't take to a blood supply. Fillers are more predictable as they don't need a blood supply to remain viable. I hope this clarifies things for you.
@Nowara84 2 жыл бұрын
Hello doctor how are you ? Iam New in your channel , watching you from Casablanca,Morocco . I have undereye hollowness and dark circles which make my face look tired all the time, i really have the way they look.i've asked a friend doctor of mine if she could do fillers for me (she always does to her patients) and she told me that she prefers that I wouldnt do fillers in my casa but to use fat transfer because fillers May cause puffyness to my eyes with time .. I've made many researches here on youtube and there are doctors who prefer fillers and others who dont and they say that even filles that are supposed to be gone in a year May stay for 10 years or more and are hard to disolve and May cause problems under the eyes...iam really lost :( and they even say that the first time making fillers May give a great result but when you do and redo the result May became catastrophic
@AmiyaPrasadMD 2 жыл бұрын
Hi Nowara84, As you can see in the video, I strongly do not recommend fat transfers under thin eyelid skin because of the high risk of complications. While a physical examination is needed before making specific recommendations for you, these videos feature the ways I treat under eye dark circles in my practice, none of which involve fat transfers under thin eyelid skin: kzfaq.info/get/bejne/h6imnc2n3bbYYps.html kzfaq.info/get/bejne/iZyPobeD15fYmaM.html kzfaq.info/get/bejne/oLeFlZlot9bFcYE.html kzfaq.info/get/bejne/iK56oseTmZmbn2g.html
@akap_987 Ай бұрын
Doctor, how about lifetime costs of these HA fillers? What are the other risks of the fillers?
@AmiyaPrasadMD Ай бұрын
Hi @akap_987, Longer lasting treatments like tear trough implants do eventually need to be changed as facial dimensions change with age, and many patients don't find tear trough implants comfortable. Hyaluronic acid fillers do feel more natural and comfortable, and are more precise, which are considerable advantages, even if they do require periodic maintenance. Fat grafting under thin eyelid is highly prone to complications, so is not recommended. You can refer to this more recent video about the options to treat under eye hollowing - kzfaq.info/get/bejne/iaxhgpCltbyrf2Q.html
@xalbatross1 3 жыл бұрын
I'm just in New Jersey.. im so sick of my hollow under eyes they're really aging me. It's probably time for me to venture over to your office!
@AmiyaPrasadMD 3 жыл бұрын
Hi A, "Tired of looking tired" is perhaps the most common reason for people wanting their eye area treated. We can help you whenever you are ready. Hope to see you soon!
@Carolina-ln7bi Жыл бұрын
I know I’m 3 years late but I have hollowness with bags. My doctor will not give me fillers without removing the bags first because he said that it will create a knot. What is your thoughts?
@AmiyaPrasadMD Жыл бұрын
Hi Carolina, If you have puffy eye bags, and hollowness, I would treat the eye bags first because the contrast of the elevation caused by the bags can make the adjacent areas appear hollow. You can refer to this video about it - kzfaq.info/get/bejne/h5aBnLF5nLK5hn0.html
@myyoutubechannel9924 3 жыл бұрын
Hey medical doctor Can fat be injected to upper eyelids and what do you think the results will be? Is it true that fat lasts for only 6 to 8 months or is it long lasting
@AmiyaPrasadMD 3 жыл бұрын
Hi, Yes, fat can be grafted to the upper eyelids, and I have done it in the past, but prefer filler as it's more predictable. Fat grafting last longer than fillers. You can refer to this video about it, with results and information about fat grafting to the upper eyelids starting at 1:50 kzfaq.info/get/bejne/mql0haWfzMfVZmQ.html
@nurgulkyn 3 жыл бұрын
Hi doc, i love your videos! Im a 27 female with very hollow under eyes. I tried hyaluronic filler (thin, not crosslinked) + prp various times. They only last me about 2 weeks, then its all gone. Should i use a crosslinked HA filler this time? My injector told me that crosslinked fillers will cause my under eyes to sag over time, is that true?
@AmiyaPrasadMD 3 жыл бұрын
Hi Nurgül, Pretty much all hyaluronic acid fillers are crosslinked. Your short lived results may have been due to the way the filler was placed, or not enough filler was used as initial results may have been due to temporary swelling. I suggest you see a doctor for treatment as you only indicate an injector. And no, fillers will not cause your under eyes to sag, which is also why you should be taking advice and treatment from an experienced doctor. I hope this helps you.
@nurgulkyn 3 жыл бұрын
@@AmiyaPrasadMD thank you doc, i appreciate your answer. She told me that it wasnt crosslinked and very thin! And yeah, she scared me with her claims. Actually she would use a lot, but weirdly it would dissapear in some days...
@AmiyaPrasadMD 3 жыл бұрын
You're welcome, @@nurgulkyn. I do suggest you try hyaluronic acid filler with a more experienced and knowledgeable doctor to see if your results improve, and last longer.
@nurgulkyn 3 жыл бұрын
@@AmiyaPrasadMD thank you i will see:)
@AmiyaPrasadMD 3 жыл бұрын
You're welcome, @@nurgulkyn!
@alikhankhan442 2 жыл бұрын
Hello doc.i m told by my cosmotologiat that ubder eye fillers cause bruised shape after few months if injected to whole under eye lid so he recomends to fill only orbit area.please guide me i want to get rid of under eye hollowness how to fo that
@AmiyaPrasadMD 2 жыл бұрын
Hi ali khan khan, The filler itself won't cause bruising, but it's the technique of the injector that may cause bruising. I suggest you see a surgeon with more experience with lower eyelid anatomy for a second opinion as a cosmetologist is not a doctor, and not a surgeon. I hope this clarifies things for you.
@loren4134 Жыл бұрын
hello! is lower blepheroplasty good for hollows, sunken eyes?
@AmiyaPrasadMD Жыл бұрын
Hi loren, Lower blepharoplasty is mostly used for treating puffy under eye bags caused by prolapsed orbital fat. However, in some case the elevation of the puffiness can cause the adjacent area to look relatively hollow. In these cases, lower blepharoplasty can improve the relative hollowing. You can refer to this video about it - kzfaq.info/get/bejne/h5aBnLF5nLK5hn0.html
@mensajesprofeticos2598 2 жыл бұрын
I had belotero under my eyes and I do not recomend nobody to take belotero. To me was the worst thing that I did. I got swollen and after that my hollowness looked deeper.
@AmiyaPrasadMD 2 жыл бұрын
Hi Kari, Sorry to hear about your problem. I actually don't administer Belotero to my patients since it doesn't completely metabolize, which can risk patient safety. With that said, it's important to remember that results are determined by the doctor's judgment and technique more than the filler material itself. You can refer to these videos about it: kzfaq.info/get/bejne/nN2EdaaarK21o2g.html kzfaq.info/get/bejne/oqdmnMilqNy-lmw.html
@evav1633 5 жыл бұрын
Hello Doctor, I have genetic dark circles. I been using foundation since I was 12 and now I’m 22. I would like to change that. Do you recommend prp ? I don’t want to get fillers. Do you know any good doctors in Santa Barbra/ Ventura CA area? Please answer
@AmiyaPrasadMD 5 жыл бұрын
Hi Eva V, I do normally treat dark circles with PRP, but lasers or radiofrequency can also help, depending on the case. I'm not familiar with doctors in your specific area who use PRP. You can refer to this video about dark circle treatment - kzfaq.info/get/bejne/h6imnc2n3bbYYps.html
@evav1633 5 жыл бұрын
Amiya Prasad, M.D. Thank you for answering! Are dark circles and hollow eyes the same thing ? And are they treated the same ?
@AmiyaPrasadMD 5 жыл бұрын
Hi Eva V, Dark circles and under eye hollowness are two different issues, but they can occur at the same time. If you have hollow under eyes and dark circles, PRP and laser treatments will not be enough to treat the lack of volume, so a filler or implant will be needed for volume. I hope this clarifies things for you.
@JohnCena-xj2lb 4 жыл бұрын
Sir i have under eye pigmentation and. Hollow too..i n thinking of going for filler..but scared too..does it have any permannt damage...my under eye skin is very thin too....m from india ..and is der any swelling after getting filler
@AmiyaPrasadMD 4 жыл бұрын
Hi John Cena, There is no damage that occurs with hyaluronic acid filler, but the technique and experience of your doctor are important to avoid and deal with any potential issues. There could be slight swelling and bruising after filler treatment, but these can are usually temporary. Eyelid skin is normally very thin as it's the thinnest skin in the body at only 0.5mm thick. I hope this clarifies things for you.
@sonyasever7625 Жыл бұрын
I'm 28 and have disgusting nasolacrimal groove since childhood, i want smth permanent, i don't want migrating fillers in my face
@AmiyaPrasadMD Жыл бұрын
Hi Sonya Sever, The problem with a "permanent" treatment is that facial dimensions aren't permanent, as the face gets smaller with age-related volume loss of bone, muscle, fat, soft tissue, and thinning skin. While a tear trough implant may last longer than filler, many people who end up having them don't find them comfortable, and eventually it will need to be replaced when it no longer fits the dimensions of the face. You can refer to this video about why there are very few permanent cosmetic procedures - kzfaq.info/get/bejne/iuCBgqahmri2qok.html
@linosforthcat3830 3 жыл бұрын
Can fat grafting or fillers under the eyes cause blindness?
@AmiyaPrasadMD 3 жыл бұрын
Hi Tonya S, I don't advise fat grafting under the eyes as seen in the video due to high risk of complications due to the behavior of grafted fat. There are also risks in injectable filler placement under the eyes, but these risks are reduced and minimized by the experience of the practitioner. I made a video about risks of filler under the eyes, with risks of blindness discussed around the 4:24 mark - kzfaq.info/get/bejne/oqdmnMilqNy-lmw.html
@pareensachdeva 5 жыл бұрын
Doctor, could you please explain the difference (mechanism, effectiveness) between injecting PRP & topical application of PrP with derma roller with respect to treating 1. Hair thinning 2. Under eye hollows Thanks
@AmiyaPrasadMD 5 жыл бұрын
Hi Pareen Sachdeva, 1. I don’t administer PRP alone for hair loss because it has a limited effect on hair, usually just short-term hair growth. Also, the number of sessions needed does vary, and the longevity of results is unpredictable. Hair Regeneration is a PRP combination treatment where PRP is the activator of the main ingredient extracellular matrix by ACell. Hair Regeneration is a one-time treatment for most patients, and can last up to 5 years and beyond, depending on the aggressiveness of the hair loss pattern. You don't need repeat injections periodically. PRP injections for hair loss are needed indefinitely. Hair Regeneration patients can stop using minoxidil completely, or be weaned off it to prevent to a sudden hair shed. 2. PRP can treat under eye discolorations,dark circles, thicken thin eyelid skin, and improve skin quality to treat issues like wrinkles, but it cannot add a significant amount of volume to treat under eye hollows. A hyaluronic acid filler like Restylane or Juvederm can be used with PRP to help with volume. I advise injection for this treatment. I generally don't advise use of dermarollers because depth and aggressiveness are difficult to control with an untrained hand, and the rolling motion unnecessarily stretches the microholes. I hope this clarifies things for you.
@pareensachdeva 5 жыл бұрын
Amiya Prasad, M.D. thank you. This information is very helpful. Could you please specify if the extra cellular matrix you use is plant-based?
@AmiyaPrasadMD 5 жыл бұрын
Hi@@pareensachdeva, Extracellular matrix is not plant-based. It is made specifically from porcine bladder because of it's remarkable healing and regenerative properties. It is sterilized so no porcine material remains, but use with religious or dietary reasons is entirely up to the individual. I hope this clarifies things for you.
@pareensachdeva 5 жыл бұрын
Amiya Prasad, M.D. yes, thank you. Is there a plant-derived alternative that you would consider or recommend?
@AmiyaPrasadMD 5 жыл бұрын
Hi@@pareensachdeva, Sorry, there is no plant-based version of extracellular matrix.
@capgains 4 жыл бұрын
Does this improve the appearance of dark circles
@AmiyaPrasadMD 4 жыл бұрын
Hi capgains, Filler can be part of treating dark circles if a lack of volume under the eyes is a contributing factor. You can watch these videos about dark circles and their treatment: kzfaq.info/get/bejne/h6imnc2n3bbYYps.html kzfaq.info/get/bejne/iZyPobeD15fYmaM.html kzfaq.info/get/bejne/oLeFlZlot9bFcYE.html
@smalik4854 5 жыл бұрын
What if you have severe hollow sunken under eyes and the fillers pluss prp are to no help at all for the volume loss??
@AmiyaPrasadMD 5 жыл бұрын
Hi shaista malik, Your question is a little unclear - did you already have filler and PRP done, and it didn't help? The safer options for under eye hollowing are shown in the video.
@smalik4854 5 жыл бұрын
@@AmiyaPrasadMD i know fillers etc are the better and safer option but it doesn't help with severe hollowness under eyes where you more volume loss
@AmiyaPrasadMD 5 жыл бұрын
Hi@@smalik4854, I can't say for sure they won't help your condition if I haven't examined your eye area. Tear trough implants are also featured in the video. I hope this helps you.
@justinajones3000 4 жыл бұрын
@@AmiyaPrasadMD Even though not your cup of tea, I like the fact you have done the implants.
@kprema2590 2 жыл бұрын
Hai doctor How to remove dark circles under eyes and around mouth Plz suggest best tre
@kprema2590 2 жыл бұрын
Plz suggest best treatment for dark circles 😔
@kprema2590 2 жыл бұрын
I'm 27 years old. I have dark circles under eyes and around mouth Which treatment is best Plz reply me doctor
@AmiyaPrasadMD 2 жыл бұрын
Hi k prema, While a physical examination is needed before making specific recommendations for you, these videos feature the ways I treat under eye dark circles in my practice: kzfaq.info/get/bejne/h6imnc2n3bbYYps.html kzfaq.info/get/bejne/iZyPobeD15fYmaM.html kzfaq.info/get/bejne/oLeFlZlot9bFcYE.html kzfaq.info/get/bejne/iK56oseTmZmbn2g.html
@isurudanoj3023 5 жыл бұрын
Dear sir , i have loss my crown area hair a lot and remaining are very thing . i am still 24 years old.but my body hair (leg , chest,back) are very thick and the volume is a lot any suggestion please?
@AmiyaPrasadMD 5 жыл бұрын
Hi isuru danoj, If you have male pattern hair loss starting in your 20s or younger, you are likely highly DHT-sensitive, and need a DHT-blocker like finasteride to control it, and slow hair thinning. The Hair Regeneration treatment can thicken thinning hair, and stimulate growth from dormant hair follicles, but it cannot block DHT-formation. DHT can have the opposite effect on body hair where it grows thicker and longer, so you can have thicker than usual body hair while having thinning hair at the scalp. I hope this clarifies things for you.
@isurudanoj3023 5 жыл бұрын
@@AmiyaPrasadMD Sir , If I use finasteride will my body hair thin ? and head hair will thick ?
@AmiyaPrasadMD 5 жыл бұрын
Hi@@isurudanoj3023, Sorry for the confusion. What I meant was DHT does contribute to body hair growth, while also causing hair thinning in men who have scalp sensitivity to DHT. It can slow hair thinning on your scalp, but it will not thicken your scalp hair significantly. If you want to thicken thinning hair, I recommend the Hair Regeneration treatment along with finasteride for a synergistic effect, and to also extend the effectiveness of the treatment. I hope this clarifies things for you.
@raygin6581 3 жыл бұрын
Dont fillers attract water and puff up?
@AmiyaPrasadMD 3 жыл бұрын
Hi Ray Gin, Hyaluronic acid fillers do attract a small amount fluid, but not so much that causes significant swelling in most people. I hope this clarifies things for you.
@uzmamohammadajazshaikh2242 Жыл бұрын
Sir is nano fat grafting good for sagging skin
@AmiyaPrasadMD Жыл бұрын
Hi Uzma Mohammad ajaz Shaikh, It's more complicated than a yes or no answer as grafted fat behaves unpredictably once removed from its original blood supply. You can refer to this video about it - kzfaq.info/get/bejne/mJldkrFixp-7gWw.html
@bellarose8511 5 жыл бұрын
What about fat repositioning?
@AmiyaPrasadMD 5 жыл бұрын
Hi Bella Rose, I will have a video soon about fat repositioning. It still technically a fat transfer, where the fat may not take to a blood supply. Many doctors who first advocated fat respositioning no longer do so as sculpting fat properly to avoid a hollow look, or filling the upper cheek-eyelid junction are much more predictable procedures. I hope this clarifies things for you.
@bellarose8511 5 жыл бұрын
@@AmiyaPrasadMD Is it true or likely that removing the fat for lower bleph may cause worse hollowing especially over time? What's the best solution for under eye hollowing?
@dakshbajaj1255 10 ай бұрын
If someone has undergone fat grafting for under eyes please share your review
@AmiyaPrasadMD 10 ай бұрын
Hi @dakshbajaj1255, There are comments on my other videos from people with lumps under their eyes after fat grafting, despite me advising against the procedure in several videos. You can either look for these comments, or take advice from me after over 25 years of experience as a specialist eyelid surgeon not to have fat grafting under thin lower eyelid skin. I hope this helps you.
@dakshbajaj1255 10 ай бұрын
@@AmiyaPrasadMD thanks! didn't expect you would reply since this was uploaded 4 years back. Do you still place infraorbital rim implants under the eyes? I know fillers are mostly used to treat under eye depression but do you on certain instances use implants as well? Are there any complications apart from them being slightly visible? I have hollows and I am pretty young and have been obessesing them for some time now but I would like to get something permanent and move on from it. Fat grafting is something I thought would be helpful since it is natural but as you mentioned and as I have read from the comments and from various other sources, seems like there is a lot of individual variance but mostly the fat doesn't stay and it can cause lumps, irregularities as well.
@AmiyaPrasadMD 10 ай бұрын
Hi@@dakshbajaj1255, A patient with tear trough implants is shown in the thumbnail of the video, as well as in the video, so yes I do place them. Tear trough implants are not as comfortable, or feel as natural as filler, which patients say after they have them done. Also, all facial implants are not permanent as the face gets smaller due to aging, so eventually they won't fit, but they do last a long time. There are advantages and disadvantages to each option, but I would still rule out fat grafting under thin eyelid skin because of the high incidence of complications. I hope this clarifies things for you.
@dakshbajaj1255 8 ай бұрын
@@AmiyaPrasadMD Hey doctor, Do you use custom infraorbital implants or standard implants? And how do you usually place them? Through transconjuctival approach or through lower eyelid incision? Which approach is basically better so that lower eyelid doesn’t retract?
@AmiyaPrasadMD 8 ай бұрын
Hi@@dakshbajaj1255, Please refer to the replies to this same comment on other videos.
@RiderShot254 2 жыл бұрын
You always recommend for fillers…y so?..
@AmiyaPrasadMD 2 жыл бұрын
Hi HardShot, When I recommend fillers, I explain why I recommend them. For the under eye area as explained in this video, they are the safest, most predictable, and they don't require surgery. Patients find fillers more comfortable than rigid implants once they are actually placed, and fillers avoid the common complications, extensive and expensive revision surgery that may be needed with complications of fat grafting under the eyes. I hope this clarifies things for you.
@RiderShot254 2 жыл бұрын
@@AmiyaPrasadMD yeah got it…thanks for the clarification Doc…🙏🙏🙏…
@AmiyaPrasadMD 2 жыл бұрын
You're welcome,@@RiderShot254
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