Posted on: December 27, 2012 13FILLERS1-articleLarge

NY Times : Perchance to Make You Look Rested

Perchance to Make You Look Rested Erin Baiano for The New York Times Dr. Anne Chapas performs a tear-trough filler procedure on a patient. By KAYLEEN SCHAEFER Published: December 12, 2012 BAGS. Puffiness. Dark shadows. Circles.  Even as we delight in telling friends and colleagues that we are crazy busy during …

Perchance to Make You Look Rested

Erin Baiano for The New York Times

Dr. Anne Chapas performs a tear-trough filler procedure on a patient.

By KAYLEEN SCHAEFER
Published: December 12, 2012

BAGS. Puffiness. Dark shadows. Circles.

 Even as we delight in telling friends and colleagues that we are crazy busy during the holidays, imperfections underneath the eyes haven’t yet become a way to impress anyone with just how time-pressed we are.

They just make us look tired.

Over the years we’ve been willing to apply almost any salve to the thin-skinned half moons. Favorites include cold cucumber slices, eye serums with caffeine and Preparation H. Or there’s the nuclear option:blepharoplasty, which removes excess skin and fat from the eyelids to make them look smoother.

But recently another fix has emerged: a dermatologist-offered procedure called tear-trough fillers, during which hyaluronic acid such as Restylane or Juvéderm is injected on top of the orbital bone to make the eyes appear better rested. “For most patients, all you need is one syringe,” said Dr. Elizabeth K. Hale, a dermatologist at the Laser & Skin Surgery Center in New York.

Darlene Anderson, 44, who owns a specialty grocery truck in Stamford, Conn., had the 15-minute procedure, which costs from $600 to $1,000, after noticing some hollowing under her eyes.“More than anything it makes me look really rested and fresh, like I got a good night’s sleep and have been drinking lots of water,” she said.

Patients aren’t yet seeking tear-trough fillers, which can last from six months to a year, the way they might ask for Botox for forehead wrinkles, but they’re becoming more popular, dermatologists say. “People come in and say, ‘I look tired when I’m not’ or ‘I look old,’ ” said Dr. Anne Chapas, the founder of Union Square Laser Dermatology in New York. “This procedure provides immediate gratification. You see it the next day.”

It is part of a trend against erasing lines one by one, as if filling in cracks in a sidewalk, and toward adding overall volume to the face in the contours like the cheekbones or eye orbitals.

Hyaluronic acid is not approved by the Food and Drug Administration for use in the tear tracts, but “I don’t think it matters,” said Dr. Ilyse Lefkowicz, a dermatologist at SkincareRX in New York. “People are going to use it off-label, and if used properly, it’s safe.”

Techniques for injecting tear-trough fillers vary. Some dermatologists use round-tipped cannulas (after an initial needle puncture) which they said bring less chance of bruising, while others prefer regular needles to help them be as precise as possible in the area. The choice of filler differs as well, from Restylane to Juvéderm to Belotero.

Injecting the eye area is not without risks. If the filler blocks a retinal artery, it can cause blindness. “I think about this every time I do it,” said Dr. Julie K. Karen, a New York dermatologist. Other side effects that may last up to 48 hours include bruising, bumps, swelling or a so-called Tyndall effect, which causes the under-eye skin to look bluish.

Which is why, Dr. Hale said, “I always tell people to bring concealer.”

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