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Restylane for malar bags – amount needed for correction?

Dr. Dean Kane Q & A Q. I got Radiesse injustione just above my cheekbone to help with malar bags. My bags are now going back and I’m considering Restylane in the tear trough. Is the typically amount one syringe for two eyes. I know it’s just a guess but it helps to have a range. Is it acceptable to preform crows feet Botox at the same treatment or can this eliminate the need for Botox in this area. A. ​I am pleased that you had improvement of your malar bags with Radiesse! We try to camouflage the nasojugal line with fillers which many times will worsen the appearance of this triangular fullness along the centro-lateral cheek. ​ ​Malar bags are made up of spongy tissue which hold onto water. They appear during allergy season or other times of blood vessel congestion like crying or excitement. Other than anti-histamines and cool compresses, there is little available for these watery compartments. ​ Hyaluronic acid (HA) gels of different consistency are used to fill or project folds, creases, furrows and lines. Due to their attraction of water, they commonly add more fullness or push up on the malar bag. ​ Due to the range in consistency of HA’s, Restylane is more commonly used in the dermis of the skin and therefore superficially along the nasojugal fold or tear trough. I prefer Restylane Lyft or Juvederm Voluma injected deep under the muscle to project the cheek upwardly under the depressed tear trough fold. Typically, 1 cc of Lyft or Voluma is used on each side with added filler every 1 to 3 months until you reach your desired result. ​ ​I hope I was helpful. Consult with your injector or a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgeon for proper evaluation and recommendations. All the best!
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