Tear Trough Rejuvenation Steps
Step 1: Anaesthesia
This is an outpatient treatment that is very well tolerated using minimal anaesthesia.
Topical anaesthetic cream can numb the lower eyelid skin in 10-20 minutes prior to treatment.
A very small local anaesthetic injection is given under the skin at the entry site for the reinforced PixL cannula (Mr Ataullah uses this fine blunt-tipped tube in preference to a needle when treating hollows around the eyes).
Restylane filler also has some anaesthetic mixed in so this further numbs the area being treated.
Step 2: The Procedure
Tear trough rejuvenation has for several years been performed using a fine needle to deliver the HA filler beneath the skin and muscle in the tear trough area. This has proved a very effective method in improving the appearance but is inevitably associated with some risk of bleeding / bruising and a tiny risk of needle injury to the tear ducts and eyeball.
Mr Ataullah now performs tear trough rejuvenation using a specially designed blunt-tipped cannula (the reinforced PixL cannula).
The reinforced PixL cannula has the advantage of minimising injury to blood vessels (so reducing risk of bleeding / bruising) and minimising the risk of injecting the gel into a blood vessel. The cannula can deliver the gel in the form of thin fine threads and so reduce the risk of a lumpy appearance.
One or two cannula entry sites are marked on the outer part of the lower eyelid /cheek junction and outer corner of the eyelids. A tiny entry hole is made through the skin and the cannula introduced through this to enter the space between the muscle and the lower bony rim of the eye socket.
Multiple fine threads of Restylane are delivered to the tear trough area and the area is moulded to ensure a smooth contour and even correction of the tear trough deformity.
The improvements are instant with usually only a mild degree of swelling or bruising that settles after a few days.
Step 3: Post-Treatment care
It is important to avoid pressure on the treated areas overnight so the gel does not get inadvertently displaced. Avoid rubbing the eyes for 2-3 days. You should rest semi-upright with cushions by your side to prevent you sleeping on the side or the front of your face for the first night following treatment.
Avoid heavy straining and vigorous exercise for 2-3 days.
Cool packs can help minimise any bruising and swelling.
You can also apply some moisturiser (e.g.Auriderm XO which also contains some agents to reduce bruising) and if you do notice some slight lumpiness then this can be gently massaged to remould the gel to further smooth the appearance in the first 2-3 days after treatment.
Repeat Treatments / Top-up treatments
When treating the tear trough I aim to achieve a good symmetrical result from the first treatment. However I prefer to be conservative to avoid an unnatural-looking overfill or puffy appearance to the eyes.
Any mild bruising or swelling may take a 2-3 weeks to settle. After this period if you are aware of a residual hollow which may benefit from further treatment then I would be happy to see you with a view to performing a top-up treatment.
With conservative treatment and the use of the reinforced PixL cannula it is very uncommon to have an excessively swollen or lumpy appearance that persists despite massage for 2-3 weeks. However if this is the case then I may need to dissolve this with a hyaluronidase injection to the area.