Restylane Injections Under The Eye; 5-FU Injections For Fat Grafting & Scar Tissue Removal

Date: August 30, 2006
What: Restylane injections under the eye; 5-FU injections for fat grafting problems; philtral column augmentation
Why: To correct undereye hollowness, scar tissue, excess fat removal via 5-FU (Fluorouracil) injections
Surgeon: Jonathan Hoenig, M.D.
Where: Beverly Hills, California
  nonchalant

I had fat grafting in May of 2004 and had some scar tissue form under the left eye after prolonged swelling presented itself.  As time went on, it made my undereye look even more hollow than they were.  In fact, on many photos the flash cast an awful shadow, giving the appearance I had been socked in the eye.  This was apparently due to the flash not reaching the area which was blocked by the ridge of scar tissue and/or excess fat.  

After many accolades on the message boards, I made an appointment with Dr. Hoenig for Restylane injections under the eyes.  I had had Restylane before but never under the eyes.  It had always lasted about 3 months, max, in my lips or lip borders but had heard Restylane lasted a lot longer in this, and in the cheek, area.  I'll give it a go and see what happens...

I had already filled out my paperwork online so as I met with the office staff, I was well-prepared.  I had a chance to visit with Danya Hoenig who is one of the sweetest, most beautiful women you will ever meet.  Then I met with Dr. Hoenig and we talked about my concerns (the fat/scar tissue ridge under my left eye that caused a shadow and caused me to look hollow above it, as well as nasolabials and lip augmentation).  He suggested Restylane under the eyes and some 5FU (Fluorouracil) in the fat/scar tissue issue (heh).  He had guessed I had southern Italian in me (My paternal side is actually from Palermo) by the very thin skin he spotted under my eyes as well as inner arms (although not to bad yet, he said).  He told me that I need to be very careful with getting fat under my eyes.  He also said he didn't want to inject my nasolabials because 'everyone should have some form of nasolabials (even babies)'. He also said no to my lips because he felt they were big enough already but would inject my philtral columns (ridges).  Being a patient of his, he didn't want me to look "done", which I respect.

Next, I had a topical anesthetic applied and waited for full effect and later an injection into my upper gums to numb the area for philtrum.  I usually get a nerve block for facial injections so the topical only concerned me a little.  However, the injections barely hurt at all!  The philtral columns did hurt a bit though, but with the local beforehand, it wasn't too bad. 

We then discussed the 5-FU option for the ridge.  5FU, also known as Fluorouracil) is a chemotherapy drug use to stop the repair of DNA and therefore kills cancer cells.  It is also used in breaking up scar tissue/collagen after Sculptra injections and other treatments, but is usually more effective immediately post-op. We'll see if it works.  He said that I may need abut 3-5 tx before it hopefully solves the issue.

I love the result, although I know I am a little swollen, especially from the 5FU 

Oh, and I also got another prescription for Triluma because the hyperpigmentation on my forehead and my cheeks are out of control!! I looked into IPL (intense pulsed light) for it, but since it is hormonal (thank you birth control pills!) it won't really do anything permanent--ergo waste of money, time and pain.  You will see the spots clearly in the pics with and without make up.  It is very distressing :(  I got on the pill about 5 months ago and any little spots that I had before were nothing compared to what I have now.  I wish my entire face would all turn darker so I'd look tan and not have to worry about evening it all up with tanner.  What a pain in the butt this really is.  Dr. Hoenig essentially said it was a chronic "disease" and that it will never truly go away long term.  So unfair.   Those of you who know me, know I used to have pretty even skin tone.  I went on OBAGI for post-inflammatory hyperpigmentation and then it seems non-inflammatory type (post-acne) hyperpigmentations have been popping up ever since.  I sometimes truly wonder if I was made more sensitive to UV light either by the OBAGI or the tretinoin.  Who knows, but it is very distressing.  If you have no brownish hyperpigmentation and go on either hydroquinone or tretinoin, take note if you develop it afterwards.

Anyway, on day 2 I am still a little swollen but I LOVE swelling hehe! I will go back in three weeks for possibly more depending upon the end result. Dr Hoenig undercorrected to be safe.  I love Dr Hoenig's aesthetic eye, bedside manner, staff and most importantly his skill and will definitely choose him for eye work when I need it.  We already discussed something to solve the thin skin issue, but only by lessening the playing field, so to speak, and not truly thickening the skin itself.  I may look into Sculptra again but that bump I got from my second injection keeps me from trying it again.  Like I said, aging sucks.

Here are the pics!  Be gentle, I have very little make up on my facial skin.   Even less in my afters.

shadow under left eye	you can see the ridge under my left eye (your right)	topical anesthetic applied
Restylane Injection	you can really see the ridge on my left eye here, it makes my hollow look far worse	Restylane Injection under problematic eye
5-FU injection in ridge	After Resty to undereyes, upper cheeks and philtral columns.  You can still see the ridge but let's hope it goes down from 5-FU	After Resty to undereyes, upper cheeks and philtral columns
BAD PHOTO!!! 6 hours post injection, no make up.  Note swelling under left eye	7 days post injection (with make-up) Note hyperpigmentations are already better!!!	7 days post injection (with make-up) no flash
7 days post injection (with make-up)	7 days post injection (with make-up)	7 days post injection (with make-up)

I think I will get some injected into the upper, inner right eye.  That asymmetry is bugging me, especially when applying eyeliner.

Marianne