Restylane has become the filler of choice for the lower eye area for long lasting correction. Juvederm and Hydrelle simply have too much hyaluronic acid content and are at risk for swelling.

For patients contemplating their first injection we usually recommend Prevelle, which does not last as long but also is quite safe.

For patients who need greater and more permanent correction we steer away from semipermanent fillers in favor of LiveFill(R) often performed with an ultrshort incision cheeklift (USIC (R)).

In any event, there are many choices now that were not available a few years ago.

Hi O,

The amount of Restylane typically required to fill the lower eye lid hollow varies depending upon the individual patient. 

I find that between 0.3 cc to 0.5 cc per side is used in the majority of patients.  I do not use more that 0.5 cc per side at one visit.  If that is not enough, more can be added at later visits.

Most important to choose your injector carefully in this delicate and unforgiving area.

Good luck and be well.

Dr. P

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Dear Oulipo

Tear trough hollows vary quite a bit. The amount of filler need also varies. Most patients need significant volume under the eyes. In a study I recently completed looking at 400 consecutive under eye Restylane treatments, the average volume was 1 ml under each eye.

However, I have some patients who needed less and others who needed much more. Generally I would recommend a consultation with an experienced injector to be assessed regarding what you need. This is a great treatment option.

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