My filler of choice around the eyes is restylane for a number of reasons.

1. Restylane is soft and pliable and can be dissolved if there is ever an issue.
2. Unlike Juvederm which can fluctuate in swelling pretty dramatically from one day to the other, restylane has much less of these fluctuations and hence gives a more uniform and predictable result. When injecting filler around the eyes, even a little bit of change in swelling can make a dramatic difference. Juvederm tends to have many more of these fluctuations than restylane. This is not as big of a deal when injecting to the lips or laugh lines, but around the eyes it can make a big difference.
3. I would urge you to not have radiesse injected close to the eyes. I use radiesse a lot and think it is very nice for temples, cheeks, jawlines, hands, etc. It is way too hard and unpredictable around the eyes.

Restylane injections around the eyes can be one of the most cost effective ways to improve your appearance. It can make a dramatic difference in the way you look, and it tends to last a very long time. For example, restylane injected to the upper eyelids and brows can last upwards of 2 years or more. Restylane injection to the lower eyelids tends to last a little less: about a year or so. Even after a year you might need a fraction of what you needed the first time.

Restylane, and fillers in general, tend to last much longer around the eyes than around the mouth. If you had restylane or juvederm injected in your lips and it only lasted less than 6 months, do not think that it will last such a short amount around your eyes. It will still have a long lasting result.

what about lumps? Lumps from restylane injection around the eyes is a function of technique. If you had lumps from restylane injection it does not mean that you have a reaction to restylane or that you will have the same issue in the future. It just means that the technique used was not perfect. You should not have lumps after treatment! Even if lumps do occur, they can usually be treated with gentle massage, or be dissolved by injection of hyalunonidase.

While other surgeons are able to lower the hairline only minimally with a one stage procedure, the technique I use can lower the hairline by at least an inch to potentially over 2 inches in one stage without having to use a tissue expander or balloon. Try to compare apples to apples. Most before and after pictures you will see online from other surgeons for the hairline lowering surgery are of patients who have had a tissue expander. All the before and after photos on our website are of patients who have had a one stage procedure without the use of a tissue expander. This is a huge difference. I firmly believe that for patients who need 2 inches of reduction or less, the one stage procedure should be the surgery of choice. For those patients who need over 2 inches of reduction, a tissue expander should be considered.

Regardless of how "tight" your scalp might be, if you need less than an inch and a half (4 cm) of a hairline reduction, you should NOT need a tissue expander. Although I can never guarantee how much hairline lowering can be performed with the one stage procedure, I have never not been able to lower it by at least an inch and a half when needed.

Having a tissue expander in place is not much fun. It is weeks and weeks of walking around with a balloon under your scalp needing to come into the office 2-3 times a week for expansion. For the last several weeks you are walking around like a cone head. If you do not think one to one and a half inches of hairline lowering will be enough and you do not want to risk trying the one stage procedure, then you should consider the two stage hairline lowering with tissue expander.

The majority of my patients have had consultations with other surgeons who have recommended the tissue expander. We have always been able to get a very nice hairline lowering without it. I have had a few patients where they could have probably used a little bit more of a reduction, but they were still happy with the reduction as well as not having to go through the tissue expansion process.