Optimizing Under-Eye Results with Multi-Modality Protocols

We have found that relying solely on hyaluronic acid fillers for the infraorbital area often leads to suboptimal outcomes or chronic puffiness. In our practice, we prioritize a multi-layered approach to under-eye rejuvenation by combining Platelet-Rich Fibrin, polynucleotides, and traditional fillers. We typically start with PRF or polynucleotides to improve skin quality and thickness through regenerative signaling, which addresses the underlying vascular congestion and skin laxity that filler alone cannot fix. By the time we introduce a cohesive HA filler for structural support in the tear trough, the tissue is better prepared to hold the product without migrating. We have observed that this sequence significantly reduces the risk of the Tyndall effect and malar edema. Balancing these modalities allows us to charge a premium for a comprehensive solution rather than competing on the price of a single syringe, ultimately driving better patient satisfaction and higher clinical margins.