How come Dr. Steinsapir does not use permanent filler or fat to fill in the dark circle?
One of the most important things to understand about the under eye circle is how thin the eyelid is in this region. On the cheek, there is more flexibility in the choice of fillers because lumps and bumps can and do hide out in the cheek fat. There is not such a margin for error in the lower eyelid. Therefore it is essential to work with a filler that is easily adjusted after the treatment should this be necessary. Permanent fillers lack this flexibility. For example, surgery may be needed if a lump is seen after treatment with your own fat or a filler like Artefill® or silicone oil. Even fillers like Radiesse® and Sculptra® have been reported to produce irregularities visible at the skin surface making them a less than ideal choice for this particular application.
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