Two sets of eyes with lower eye bags

Restylane Eyelight: What Is It & How Does It Work?

Written by Dr. Allan Wulc
On October 25, 2023

Unfortunately, many people experience deepening of the tear trough, which can make you look tired, even in your mid-twenties. Visually, they’re created by hollowing under the eyes. Factors that worsen deepened tear troughs include: and they’re worsened in:

  • Certain lighting because of the shadows created by the forehead bone
  • Discoloration in the eyelid skin related to allergy
  • Puffs that start to form in the lower lids as the cheek fat pads begin to droop because of gravity

 

Hollowing of under eyes

These factors, in combination with changes in bone as we get older, appears to cause most of the under eye aging changes. A deep tear trough is a result of aging and cannot be hidden with makeup. Luckily, there are options to treat deep tear troughs that don’t involve surgery; such as Restylane Eyelight.

What is Restylane Eyelight?

Restylane Eyelight was recently just approved in June of 2023 for the treatment of the tear trough.

What is a Tear Trough?

The tear trough is a hollow that sits beneath the puffs of the eyelid, and it’s one of the earliest troubling aesthetic changes that occur in our faces as we get older.  In other words, it’s the lower eyelid—where some may notice dark circles, bagging, and hollowing from various factors like aging and genetics. Everyone has tear troughs, including adolescents, children, and babies. The term tear trough was coined by Dr. Robert Flowers off rom Honolulu, Hawaii, who described it as the place where tears would flow if you were to cry. 

It accentuates the puff, because the hollow sits in the shadow created by the forehead and creates a dark circle. According to the market research provided to us by the company, 70 % of surveyed individuals feel that they look tired and older due to under eye bags.

Restylane eyelight packaging

Finally, there is a product that is presumed to help treat dark and deep under eyes! In fact, the same product—with a different name—has been used in our practice for the past 20 years.

Hyaluronic acid filler injections are the second most commonly performed noninvasive procedure in the world.  Most commonly, these fillers have been approved in the USA for the treatment of the nasolabial fold and for fine wrinkles. 

More recently, fillers have been approved to treat the cheeks (Juvederm Voluma), lips (Kysse), and to contour the Jawline (Restylane Contour).  HA fillers mimic a naturally occurring substance that is found in connective tissue, joints, and almost everywhere in the human body. 

Hyaluronic acids were first used by ophthalmologists to protect the eye during delicate cataract and corneal surgeries more than 40 years ago and HA biochemistry has now lead to products that can be used for a variety of conditions including within joint spaces, in the vocal cords, and of course, in various locations in the face to enhance our personal  appearance.

The pursuit of an FDA indication involves clinical trials that then are submitted for rigorous examination by the FDA.

All these fillers have been used “off-label”—meaning they can be used to treat any volume deficiency that a licensed injector, a physician or PA or a nurse feels may benefit a patient.

We’ve used Restylane to treat the tear trough to treat this exact same problem for the past 20 years.  I personally had tear trough injections with Restylane in 2007 by Dr. Kenneth Steinsapir and again in 2017 by Dr. Brett Kotlus.  What’s satisfying about this product is that it lasted ten years the first time and looked pretty good, but needed tweaking a decade later.  

A study by Mobin Master in Plastic and Reconstructive Surgery showed that HA filler was visible 10-12 years following treatment in the midface area, and this is what we’ve found. I’m 

What’s Special About Restylane Eyelight?

Actually, nothing. Restylane Eyelight has the exact same biochemistry as Restylane-L, the same product we’ve used for the past two decades. New box, new indication, same ingredients.

Does Restylane Eyelight Work?

In the correctly selected patient, it works very well.  You have to be healthy, not pregnant, not have had a vaccination or dental work within three weeks.  You have to have minimal bags and no under eye edema—swelling.  

The phase three study done by Galderma showed that a majority of patients were satisfied with their results 6 months and one year following their injection.

Before and after Restylane Eyelight
One of our patients after a syringe of Restylane (and one syringe of Redensity—another great product from a different company.)

How is it Done?

Restylane Eyelight can be injected under the eyelids with both a fine sharp needle and a blunt tube like cannula which layers the product in a deep  location so that it can elevate the under eye hollow and blend in with the normal fat pad fullness above. It’s done with you awake and usually in the upright position so that we can assess you in similar conditions to everyday life as you are seen by others—and when looking in the mirror.

It is generally a painless procedure.  We strive for a slight under correction because, over a period of a few days, swelling produces additional improvement.  A reassessment is done in 2 weeks , and rarely, additional filler is introduced.  

Nonetheless, the results you experience are immediate—the hollow is partially filled.

What Complications Can Occur with Restylane Eyesight?

Generally, after the procedure, swelling can be noted as well as redness and potentially bruising.  These annoying possibilities can be concealed within 24 hours with makeup, and in men, with tinted sunscreen that we can supply you with.  

Itching, swelling, edema, and bruising were reported by a percentage of patients in the phase 3 clinical trial of Eyelight. 

Filler migration, skin reactions, and blindness are all rarely described complications, with filler injections, and were not observed in the study. You need to discuss these rare complications  with your provider prior to the injection.  In our practice, the procedure is only done by an experienced physician, but even still, these potential complications exist

What if I Don’t Like the Results?

Fortunately, there is an enzyme, hylaruonidase, that can be used to dissolve filler if it isn’t to your liking.  Rarely, two treatments are necessary.  The enzyme is administered with a blunt cannula to avoid bruising and usually results are immediate.

How Long Does Restylane Eyelight Last?

I already related to you that my results lasted a decade.  The company says in their study that at one year, 84 % of patients were still satisfied with the results of the under eye filler treatment. To verify that you are satisfied, periodic checks—say at 1 year to 2 year intervals are sufficient, and when you feel that it might be time to consider another injection, you can schedule a re-evaluation.

How do I Know if I am a Good Candidate?

The best way to know if you might benefit from a treatment with Restylane Eyelight, or any other hyaluronic acid product is to schedule a consultation.  

You can send a photo to our website and our nurses and qualified staff will let you know at no charge whether your under eye area would benefit from a treatment of this sort at no obligation.

Why Choose W Cosmetic SurgeryTM for your Restylane Eyelight Injection?

Dr. Wulc is a board certified ophthalmologist, oculoplastic surgeon, and plastic surgeon with a detailed understanding of the delicate anatomy of the eye area, a long track record of successful surgeries in this location, and more than 20 years’ experience in tear trough injections. There is an art to this and we consider this one of our specialty procedures—done with care– and finesse.

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