I notice my wasting under my eyes. I have tried Sulptra -- but it is expensive and minimal results. Any other ideas

Hello, and thanks for posting.

The area under the eyes can be a tricky area to treat. The skin is often thinner in this area and sub-dermal injections with Sculptra, Juvederm, or Restylane may end up producing nodules or dermal irregularities. This is a very unforgiving area for injections which are not precisely placed. Probably one of the most common mistakes made by clinicians new to facial injections involve the under eye area and the typical problems involve nodules.

In my opinion, the best treatment strategy for this region is injection of Radiesse to a deep location right on top of the orbital ridge facial bone under the eye. Depending on the exact location of the atrophy, this filler can be injected through the mouth in order to get the product to the desired location. Or the injection approach may be from the side cheekbone.

The notion of doing Radiesse filler injections through an intraoral approach freaks a lot of people out when they first hear about it, but it is one of the most effective ways to use this agent. There is actually less pain with this approach compared with injections through the skin and there is much less bruising. This is an advanced injection technique, but one could argue that experienced injectors should be the ones tackling the under eye region anyway because of the challenges posed by this location.

I hope that this information helps and best of luck!