LAM FACIAL PLASTICS

I am an older woman who has moderate naso folds and hollowness under the eyes. I have watched your clips about laugh lines and how you don't have a "knee jerk reaction to fill them" Do you think the root problem is the hollowness under my eyes. Do you recommend I get my tear trough filled with restaylane and not bother getting my laugh lines filled. Would the filler in my tear trough help the naso labial folds as well? I would think it would, yet I am not positive.

When I do go get my tear trough fold, I am going to see a nurse practioner. I hope she is good. She will inject at the orbital bone and rim area, right. Does she inject into the mid to deep dermis to prevent the restylane from showing under my skin? I have VERY thin skin, will the product show if not injected deep enough. Hope to get some advice from you. Thanks.

a few things: consultations over the Internet without seeing you in person are not worth very much. in general, most smile lines are overfilled unless you have what i call parentheses lines that make you look like a clown. filling the tear trough must be done by a highly experienced practitioner who does it often and can show you extensive before and after photos because this is a very tricky area. injecting into the mid to deep dermis will create nothing short of a massive disaster. you need to inject under muscle over bone. most people do it with needles and bruise the stink out of you. with my cannula technique (which 99.999% do not know how to use, especially with proper blocks so you don't feel it and have no discomfort), you should have minimal to no bruising. plus i truly believe that method is much safer around the eyes. further, if you had to do only one syringe in most women who are gaunt, the number one area to make the eyes not look so tired is the anterior cheek NOT the eyelids. that would depend on how you look. btw, using a nurse practitioner is fine so long as she is an advanced injector. a monkey can inject smile lines. an experienced, qualified individual (whether it is a nurse or a doc) should do that work. it is highly technical. i have seen many M.D.'s have no idea what they are doing around the eyes.
best,
sml

Wow, that was such great information; I totally feel empowered now. I would come see you immediately, but you are in TX and I am in CA. I wish you were located in my area.
So, before I go in, I should ask to see before and after pictures? Okay, then maybe I can build up some trust. I am worried that I will be bruised and damaged under my eyes for life with those needles. I am worried the restylane will show under my eyes giving me a shadow look in addition to my already dark circles I have. Why can't they all use cannulas, Why are you the only one? I think your methods are the best.

Cannula injections are very advanced. I tried teaching it one time, and I realized that I could not risk teaching this method. It is too dangerous to teach inexperienced injectors. You are aiming the cannula toward the eyeball, and you can understand why no one is allowed to do this technique but me. It is very safe in my hands. It is also in my opinion a lot safer around the eye area than needles.
best,
sml