Same but different

A "new" filler, a shiny B&A, and a hot-off-the-press poll

Another day, another filler. The latest, from Restylane, is called Eyelight. It’s FDA approved to treat those tricky under-eye hollows.

The company press release touts “minimal crosslinking” and “a firm texture that is resistant to water absorption” — qualities that typically make a hyaluronic acid filler easy to reverse and less apt to swell (no one wants to trade hollows for bags).

But, you might be thinking, aren’t those the same qualities that make Restylane-L (the OG Resty filler) a go-to for tear troughs? Indeed, they are. Which is perhaps why the company has relaunched its classic formula as Eyelight, with fresh safety data, a new under-eye indication, and special packaging.

Eyelight is “the same [as] Restylane-L, but in 0.5mL syringes, so injectors go with less per eye,” explains Dr. Jason Bloom, a facial plastic surgeon in Bryn Mawr, Pennsylvania. He’s a consultant for the company and an overall wealth of knowledge.

Whether or not the lesser dose will prove advantageous is TBD. While it sounds good in theory — less is often more in the filler realm — many injectors already routinely split a 1mL syringe between the two eyes when treating the tear troughs and surrounding territory.

Dr. Tanya Khan, an oculoplastic surgeon in Plano, TX, tells me that the .5mL version might work for some who have minimal hollowing. However, she “almost always use[s] about 0.7-0.8 cc total, for the two eyes, because part of doing tear trough injections is blending with the cheek,” she explains. “You want to allot for filling a little within the anterior and lateral cheek too. And frequently people have lateral orbital hollowing, so it’s not just a matter of filling specifically the tear trough.”

(Ccs are the same as mLs, FYI. And in anatomy speak, “anterior” refers to the front-facing part of the cheek whereas “lateral” describes the side, or outer portion, of the cheek.)

Another interesting tidbit from Dr. Khan: While she’s always found Restylane to work well as a tear-trough filler, she actually ditched it for Revanesse Versa a few years ago, after learning that Versa produced 50% less swelling than Restylane in a head-to-head study comparing the two fillers.

That said, plenty of injectors love Restylane for the under eyes (again, largely because it pulls in less water than Juvéderm fillers, including the one that’s FDA approved for the under eyes, I’m told).

Some highlights from the Phase 3 Eyelight study…

• 87% of patients had reduced under-eye hollowness at 3 months

• 84% were still pleased through 1 year

• During the 18-month trial, researchers saw no Tyndall effect (blue tint) or product migration (complications that can cause patients to sour on filler)

While the trial merely confirmed what many injectors already knew, more filler data is never a bad thing. Plus, as Beverly Hills plastic surgeon Dr. Cat Chang points out, the new under-eye indication gives the treatment on-label credibility, for whatever that’s worth. “The FDA approval may help a subset of patients feel more safe and comfortable having the procedure performed,” she notes.

Ultimately, safety is determined by the person holding the syringe. Vet your injector carefully — their training, technique, aesthetic, and experience managing complications.

That’s more than I intended to write about a “new” filler that’s not really new.

Moving on…

Did you guys see this stunning B&A from Jenn Hollander? For those who don’t know, Jenn is a nurse practitioner, who runs the nonsurgical side of Dr. Ben Talei’s Beverly Hills practice.

This is the work of Botox (to the upper face, around the mouth, the neck), a small amount of filler (under eyes, nose, lips), and skin care. No lasers. No surgery.

The change in skin quality — tone, texture, luminosity — is pretty remarkable. The disposition of the face has also been transformed: She looks more at ease, happier even. And there’s only about six months between the two photos, Jenn says.

This is where nonsurgicals shine, IMO. I know I talk a lot about the shortcomings of certain noninvasive modalities, but that’s mainly when they’re aiming to rival the scalpel. This patient is a perfect example of injectables being used (tastefully) for their intended purpose: to “improve someone’s beauty without risking them looking strange and dysmorphic,” as Jenn notes in her caption.

In other news, RealSelf just launched its Culture Report — the results of an independent survey exploring how Americans view plastic surgery in 2023. Because I’m endlessly fascinated by public perceptions of cosmetic procedures, I found this to be a juicy read (well done, Alix Tunell!). Among the more intriguing points…

• 18% of respondents said attitudes toward plastic surgery among their social group have become more positive over the past three years.

• Both men (51%) and women (57%) attribute these increasingly positive attitudes to having more procedure options that are safe and minimally invasive with less downtime.

• 35% of men say they’ve hidden or would hide their cosmetic-treatment spending from a partner, making them 15% more likely to hide it than women. Younger people are more likely to hide costs too: 44% of Gen Zers say they’ve hidden or would hide their spending from a partner vs. 22% of Gen Xers.

• Everyone, at every age, apparently wants to look like J. Lo. Hmm…

The full report delves into the myriad ways plastic surgery intersects with celebrity, politics, money, and more. Give it a look here.

Usually, at the bottom of each newsletter, I link my latest stories (“Back Issues”), but does anyone care? Are we done with that? Maybe. I’ll leave you instead with this masterpiece from Philly plastic surgeon/satirist Dr. Christian Subbio. xx