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Kenneth D. Steinsapir, MD answers: Restylane or Juvederm for genetic tear trough deformity or hollowness?

I’m 24 years old and always have had deep hollowness under my eyes (safe to assume it’s genetic). I’m seeking fillers and have found an ophthalmic surgeon in Los Angeles, but want more options. He asking for $1,500 for 1 syringe, is this average? I’m curious whether it will help with my situation or will it make it bumpy and wrinkly when I smile. Also, should I get Restylane or Juvederm? I had Juvederm in my lips roughly 2 years ago and it went well. I’m extremely scared. Any suggestions/advice will be appreciated.


Kenneth D. Steinsapir, MD
1 month ago

The placement of filler in the under eye area is an art form and not so much a treatment technique. The price you were quoted is about right for the high end Beverly Hills and West Los Angeles practices with the most experienced injectors.   

For this type of cost, you should expect a detailed service by the actual surgeon rather than a nurse or other type of injector. This type of treatment places an absolute premium on a detailed surgical knowledge of the lower eyelid midface anatomy. For this reason, many dermatologists are not comfortable placing this treatment. Also you may in fact need more than one syringe of filler to treated the under eye area.  The longevity of the Restylane in this area is excellent and can last up to 2 years so that a well done service even on the more expensive side can be a very good value.

With regard to Restylane vs. Juvederm, these are both hyaluronic acid fillers. However, the "smoothness" of the Juvederm means that what was initially placed for under eye fill can settle into the top of the cheek creating unwanted fullness.  This type of product drift is not seen with Restylane.
 
The good news is that if you go with cheap service and are not satisfied with the results, it can be correct using the enzyme hyaluronidase. Again this type of an adjustment needs to be done by a highly experienced injector.
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