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Under Eye Bags, Dark Circles & Lip Augmentation Treatments Using Subdermal Fillers

A significant part of our practice involves the use of injectable fillers for non-surgical facial rejuvenation. We call this “minimally-invasive facial aesthetics.” We use both hyaluronic acid fillers and non-hyaluronic acid fillers to help enhance certain parts of the face.

Both women and men visit us looking for ways to rejuvenate their facial appearance; most often, their concerns are helped using subdermal fillers. Nowadays, both women and men wish to have their eyelid and face refreshed with fillers. The most common place for subdermal fillers for both women and men include under eye bags, cheeks, nasolabial folds (folds between the nose and corner of the lips), lips, and the midface, when there is loss of volume due to aging.

These types of fillers are known as hyaluronic acid (HA) fillers. They improve the facial appearance by lifting and adding volume to the wrinkles and folds in the treatment area.

Facial Fillers Can Be Used To:

  • Help to restore volume and fullness to the eyelids and face
  • Improve cheek volume loss
  • Improve under eye bags and hollowing
  • Improve jowling
  • Improve temple volume loss
  • Improve Face and neck wrinkles
  • Plump thin lips, or enhance lips
  • Improve the wrinkles around the lips (peri-oral wrinkles)
  • Improve the temple hollowing
  • Enhance the chin area
  • Enhance shallow contours
  • Soften facial creases and wrinkles
  • Improve the appearance of recessed scars

Common treatment areas include:

1) Cheek bones; loss of bone and soft tissue around the cheeks can result in the worsening of nasolabial folds and jowling. Fillers to the cheeks can not only help rejuvenate the cheeks but also improve also areas of the face including the nasolabial folds, under eyes, marionette lines, and jowls.

2) Nasolabial folds: folds between the nose and the corner of the lips. Once the cheeks have been adequately augmented and there are still nasolabial folds that need attention, direct injecting fillers into the folds can be performed.

3) Under eye hollows, periorbital volume augmentation. Injectable fillers can carefully be used to improve the hollowing along the under-eye area. Hollowing, or volume loss, usually occurs with aging and injectable fillers can help improve the targeted area. Under eye hollows can also be termed tear trough deformity, dark circles, or under eye bags. Hyaluronic acid fillers can help improve the eyelid area and hollowing under the eyelids. If there are prominent fat pockets in the lower eyelids, you may be a better candidate for lower lid blepharoplasty. Dr. Zoumalan can help determine that for you during your consultation.

When it comes to periorbital rejuvenation, Dr. Zoumalan does not just address the under-eye area. The upper eyelids, lower eyelids, eyebrows, cheeks, temples, and midface are all areas that Dr. Zoumalan will evaluate and determine if volume loss has occurred and help improve the overall periorbital area.

People that have hollowing in their upper eyelids may also benefit from upper eyelid injectable fillers. Dr. Zoumalan specializes in treating issues concerning the eyelid area.

4) Lip augmentation is a very popular area to inject. Dr. Zoumalan has studied the lip anatomy and lip aging process in detail. Dr. Zoumalan performs lip fillers for various conditions:

  • Over lip volume augmentation for thin lips
  • Asymmetric lips
  • Enhancement of the lip borders and lip philtrum (the columns of raised skin between the nose and the central upper lip)
  • Improve the corners of the lips to give a more upward turn (termed ‘happier” lip)
  • Improve the wrinkles in the lips and surrounding peri-oral area
  • Plumping lips to give them more of a youthful look
  • Enhancement of the lips where patients do not wish for a plump look but a fuller look

Different Types of Facial Fillers

There are various types of fillers that can safely be injected to improve the appearance of the face. Injectable fillers include a variety of materials, which last for different lengths of time and have different effects and uses. Hyaluronic acid fillers are safe and used to improve areas of the face. Each one is used in specific parts of the face based on Dr. Zoumalan’s expertise and the patient’s exam findings.

Hyaluronic acid fillers are injectable fillers that include hyaluronic acid, a natural complex sugar that can help bolster skin elasticity and improve appearance. It is biocompatible, supplementing the body’s natural hyaluronic acid, which age has depleted. Hyaluronic acid fillers are transparent gels that are injected with a syringe into the mid- to deep dermis of your face.

Fillers of Specific Areas

Fillers to specific areas of the face can certainly help in improving the volume deficiency people get with aging. Fillers are performed in the office with the assistance of a topical anesthetic. The procedure can take as little as 30 minutes if using hyaluronic acids. Dr. Zoumalan has introduced the use of a blunt-tipped cannula for most of his facial filler injections, which allows him to reduce the incidence of bruising and discomfort by a significant percentage in his patients.

The blunt-tipped cannulas Dr. Zoumalan uses for his facial filler injections are like the ones used in the operating room for fat grafting procedures, which has made the transition to using the cannulas in the office quite feasible. We offer this to all our facial filler patients and most if not all prefer the blunt-tipped cannulas due to comfort, safety, and decreased rate of bruising.

The Dermis Layer

The dermis is the subsurface skin layer that contains connective tissue, nerve endings, sweat and oil glands, and blood vessels. The advantage of using hyaluronic acid fillers is that they can offer long-lasting outcome without risks associated with permanent fillers and they can be safely repeated. Side effects with these fillers are rare, but may include redness, tenderness, or pain at the injection site.

If these occur, they usually subside within three days. Rarely, discoloration may occur, but this is reversible. Firmness, swelling, bumps and bruises are also rare side effects, and should subside within seven days.

Are You a Good Candidate for Facial Filler?

You may be a good candidate for facial fillers if you:

  • Are physically healthy
  • Have volume loss in certain areas in your eyelid and face
  • Live a healthy lifestyle and take good care of your skin
  • Maintain Realistic Expectations of the results
Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface. - Patient before and after picture

Preoperative diagnosis: Tear trough deformity (orbital rim hollowying) and loss of midface volume. The patient has visible eye bags, right worse than left. The dark shadows are a result of a loss of volume in the tear trough and also a result of “extra” fat that has herniated.

Procedure performed: Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface.

Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface. In this patient, Restylane was used around the tear trough and orbital rim. Juvederm was used to augment the midface and to restore the volume that had been lost - Patient before and after picture.

Preoperative diagnosis: Lower lid fat prolapse (ie bags under eyes). History of prior blepharoplasty with residual fat pads. Loss of midface volume.

Procedure performed: Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface. In this patient, Restylane was used around the tear trough and orbital rim. Juvederm was used to augment the midface and to restore the volume that had been lost. Pre and post photos are shown above.

*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.

How many syringes do you need and what are the cost of fillers? 

This is a fairly common question and it all depends on how many fillers are required are and to what level of improvement you wish to achieve. Some end up using one syringe while others require more than 3 syringes. The price range per syringe varies and we will discuss that with you once you see the doctor for a consultation. How long does it last for? After 9-12 months, the biocompatible compound is usually naturally absorbed into the body. However, some patients find improvements that last up to 1-2 years

Dr. Christopher Zoumalan is a board-certified oculoplastic surgeon in Beverly Hills, specializing in aesthetic and reconstructive oculoplastic surgery. Dr. Zoumalan is passionate about helping patients reach their ideal aesthetic and restore functionality with the leading cosmetic eyelid surgery, reconstructive eyelid surgery, and non-surgical cosmetic procedures. Dr. Zoumalan has been featured on several television shows and has traveled the world as a trusted oculoplastic specialist. Browse the video gallery below to learn more about oculoplastic procedures and treatments.
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