Optimizing Under-Eye Results with PRF and Polynucleotide Stacking

We have shifted our approach to the periorbital region, moving away from relying solely on hyaluronic acid fillers which often lead to chronic swelling or Tyndall effect. In our practice, we now lead with Platelet-Rich Fibrin to leverage autologous growth factors, followed by polynucleotides to stimulate fibroblast activity at a cellular level. This combination addresses the underlying skin laxity and thinning that filler alone simply masks. When we do introduce a cohesive polydensified matrix filler for the tear trough, we use significantly less product because the tissue quality has already improved. We find that this multi-modal strategy reduces the risk of malar edema and provides a more natural transition between the lower lid and the cheek. By focusing on regenerative foundations first, we ensure that our patients achieve a rested look without the structural heaviness associated with over-filling the delicate infraorbital space.