Dr. Joel Aronowitz - Real Patients Real Stories: Dr. A Gives Bridget a Tear Through Fillers for “Tired Eyes”
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| Dr. Joel Aronowitz |
Bridget: "Okay, here's the situation. I have never gotten fillers. I know, it's crazy. For some reason, I mean it's not that I don't want them, I mean I could do everything, right? A little lip here, a little cheek here, but you know, it's hard as the injector to like, get the time and the person to inject yourself. You know, by the end of the day, I'm like, 'Let's go, I'm out the door.' But lately, my tear troughs have just been really bothering me, and a couple of patients have been saying, like, 'Hey, you're looking like so tired,' which is like the worst thing to say. I mean, it's very nice, but like, no one wants to hear that they're tired, and I'm like, 'Really? Because I got eight hours of sleep.' So, anyway, I know that this area is a trouble area for many people. A lot of girls come to me, and men, for that matter, come to me wanting their tear troughs done. So, I figured, practice what you preach, and follow.
The first thing you want to do is, when you get your any injectables, you want to take your makeup off, because I'll get a better view of what's going on, and it's good for infection.”Dr. Joel Aronowitz: “Let's talk tear troughs. So, tear troughs represent the demarcation between the lower eyelid and the cheek. So, when we're younger, and we have a nice layer of fat throughout the lower eyelid and the cheek, we don't see any demarcation between the two structures. But as we age, we get that depression because we've lost a little bit of the subcutaneous fat, and we start to see that demarcation between the eyelid skin and the cheek skin. And that's this dark line that Bridget doesn't like. So, what we're going to do is plump that back. So, there's a filler in there that makes it so it's smooth. That way, it doesn't catch the light and show a shadow. Sometimes, we have a line there because there's less of a shadow, and it's more just hyper-pigmented, and the filler isn't going to do much for that. For that, the IPL is very helpful. So, you want to sit back, and we're going to use the depo technique here.
We're going to go right down to the bone here. We're going to depo a little bit of filler. Pull back a little bit on the plunger, so that you don't get into any larger vessel. And there's a little bit of lidocaine in there which helps us with that pain of injection. And then, I'm just going to make sure with my finger that I've spread that out nicely and smoothly. There's no bump there. I'm going to sit up, and I would say that's about 70% corrected. And I'm going to do just a little bit more toward the side of the eye there. You're doing fine. It's mostly numb. There's no, so far, so good in terms of the bruising. So, I just put a little bit more. Now, I'm just going to hold a little pressure for a moment. And it really, you don't feel it too much.”
Bridget: “Like, yeah, you feel it, but it really does not hurt.
Dr. Joel Aronowitz: “It doesn't really burn.”
Bridget: “ No, you kind of feel pressure when your needle is on the bone. How does it look?”
Dr. Joel Aronowitz: “I think the cold helps. You want to sit up? That looks perfect. That looks really nice. I think I could use just a drop more right there. Yeah, that one I put very deep. That's perfect. So, we're going to fill this tear trough here. And this is what's called a deep bow technique. So, we're going to deposit a little bit in different locations down fairly deep. And then I'm going to smooth it out. I'm going to go fairly deep because it's more forgiving if you deposit it deep. Very nice. So, now there's not a demarcation between her eyelid and her cheek. So, basically what we're doing is filling in there, and then, can you see this side again?
Bridget: “Oh, yeah.”
Dr. Joel Aronowitz: ”Perfect. That's good. You could even use just a little bit more there. And I know Bridget is more like me in terms of preferring to do less rather than more. You can always do a little bit more. Let's take a look here. This side looks real good.
Bridget: “What's happening on this side?”
Dr. Joel Aronowitz: “That side's done.”
Bridget: “It is? How did you get it so quickly? It needed a good amount."
Dr. Joel Aronowitz: “Take a look. I didn't overdo it. I under did it. So take a look and see what you think. And I'll do more if you want. I actually did a good bit more on that side.”
Bridget: “Wow. It really makes a difference.”
Dr. Joel Aronowitz: “We have a surprise for you. I'm going to use the rest. So I'm going to do the malar eminence here. This is where a woman puts rouge or puts makeup to make a more prominent cheek. And we're going to actually make a more prominent cheek. And the reason you want to put makeup there is because with age we lose volume in the cheek. And we can mask it with makeup but we can also replace some of that volume with this type of filler.”
Bridget: “You know what you do really good at? Really well? When you squeeze like that, your squeeze is kind of distracting.It hurts less.”
Dr. Joel Aronowitz: “You'll like it. You will.”
Bridget: “I mean I love cheeks for anyone.”
Dr. Joel Aronowitz: “Yeah.”
Bridget: “Did you switch that needle?”
Dr. Joel Aronowitz: “Yeah.”
Bridget: “It hurts less.Now you want to talk about after. You might swell. You might bruise.”
Dr. Joel Aronowitz: “Most people don't bruise. Most people swell a little bit because the material absorbs a little water and some more than others and some people more than other people. But I doubt you'll bruise. You want to be careful to not sneeze or laugh.”
Bridget: “Exercise? Tomorrow? 24 hours?”
Dr. Joel Aronowitz: “An hour is probably enough.”
Bridget: “And we didn't do a lot.”
Dr. Joel Aronowitz: “We didn't do a lot. But what causes bruising is if you make a hole in a vein and that hole doesn't seal or that comes unsealed later because you do something that increases the pressure in the vein. And that would be basically a Valsalva type maneuver. This. And that's things you would do when you're doing exercising. You're working out or you're laughing very aggressively or cough or sneeze violently.”
Bridget: “Okay. That was great. You're better. That hurt less than you doing Botox.”
Dr. Joel Aronowitz: “Really?”
Bridget: “Yes. I swear.”
Dr. Joel Aronowitz:“Thank you."
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