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Restylane or Juvederm Injection Safe and Effective for Under Eyes?

Is it safe and effective to have Restylane or Juvederm injected under the eyes for hollowness? If so, which is better? I had a lower blepharoplasty 8 years ago and I'm very hollow under the eyes. I am 48 years old and I have an appointment for a consultation and possible treatment this coming week, but I am apprehensive about the actual injection.

Doctor Answers (18)

Restylane is safe and effective for under eyes

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Dear Hopefulhollow,

RESTYLANE. Hands down.

Juvederm is a great filler but causes more swelling and is best not used along the periorbital area.

For best results, I would insist on getting the injections from an experienced DOCTOR (not a nurse or other injector). As a plastic surgeon, I COULD smugly tell you that we are THE best. But that would not be true.

I would though pick a GOOD ENT (facial plastics) or Dermatologist as easily but make sure they can deliver what you want and will be personally responsible for the result.

Good Luck.

Memphis Plastic Surgeon
5.0 out of 5 stars 69 reviews

Restylane, Juvederm, or other hyaluronic acids to treat tear troughs (under eye hollowing)

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Dear, Hopefulhollow,

  Your question is a good one.  I will try not to "reinvent the wheel," as I agree with many of the answers already listed above by some of the most well-renowned and experienced practitioners in our field. I agree that this is NOT an area in which you should choose your doctor based upon a price quote (instead, I encourage you to choose a practitioner who has expertise in this particular procedure and with whom you feel comfortable). Another bit of "homework" that you can do is call to insure that your physician keeps hyaluronidase in his/her office. Hyaluronidase can be injected into areas that had been treated with hyaluronic acid to break down the latter if need be. For example, if too much hyaluronic acid has been injected into any one site.

  The relatively large number of blood vessels located in and around the tear trough areas make these sites more prone to bruising after filler injections. While both Juvederm as well as Restylane (both hyaluronic acid fillers) can be used for this indication, I prefer to use Restylane, as it tends to absorb less water from your body, which results in less post-procedural swelling.

  Another thing to consider is that - due to the thin nature of the skin in the tear trough area - when a hyaluronic acid filler is injected superficially, the product can scatter light in a way that results in a persistent bluish tint to treated areas. This phenomenon, known as the "Tyndall effect" essentially creates a new problem for the patient.

  Despite the potential side effects from injections of hyaluronic acid into the tear trough areas - when performed by an experienced physician - the results can yield a remarkable, more youthful and "less tired" overal improvement in one's appearance. 

Good luck with your decision,


Monika Kiripolsky, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Eyelid surgery, Restylane, Peri-orbital hollows, hollow under eyes, tired eyes

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You ask a very good question- the under eye area needs special attention and care. The hollow contributes to a tired appearance. With blepharoplasty the area under the eye must be filled in or the eyes may look more tired in the short time when the surgical swelling has resolved.

Restylane can be used to correct the hollow very nicely. As an alternative the hollow can be fat grafted at the time of surgery or if not then- at a later date. Fat grafting gives a permanent result to the correction of the hollow.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 53 reviews

Filler along the lower eye

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Placing filler material such as restylane and juvederm along the lower lid can be done. There is a slight risk of blindnes that has been reported with this technique although it is extremely rare.  Go to an experienced injector.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Yes, it can be done, but it is a very tough procedure and should only be done by an expert

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When I say expert, I mean it. If you go to the medispa down the street, you are most likely going to be very unhappy. It can have real problems (read some of the RealSelf questions on this subject if you doubt that) if done improperly.

Even if it is done properly, it sometimes doesn't work all that great as that area can be scarred from the initial procedure and the anatomy of the area can be 'off'. Good luck whatever you do!

Restylane and Tear Trough

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Of all the areas in which we place fillers, this is potentially the highest impact region of the face. The results of a well-done augmentation of the lower lid complex can have major rejuvenating effects. However, of all the areas, this is the one in which you need to find an injector with expertise and experience in injecting this area. The potential complications can range from minor irregularities to serious injury to the anatomy around the eye. In well-trained hands, the risks are very minor. Restylane and Juvederm are probably the two safest substances to inject in this region. Web reference:

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 87 reviews

Restylane Injections Under the Eyes to Correct Hollowness

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Hi Hopeful,

I, and many others now only use Restylane to fill lower eyelid hollowness because of experience with too much swelling under the eyes with Juvederm in one of my patients, and in many patients injected elsewhere.

The safety of the injection in this area is related to the experience and skill of the injecting physician. It is a very delicate and unforgiving area so choose your injecting physician most carefully.

When performed properly, the results are excellent.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Fillers for under eyes

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Filling up the tear trough area can be a very effective option and if done well looks very natural. Juvederm and Restylane are versatile products for this area but there is one thing to be careful about: if your skin is very thin, especially toward the inner corner of the eye, you may get a bluish appearance because the products are clear. Another filler called Evolence works well in that case. As long as your injector is experienced with treating this area, they will be able to make a good recommendation.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 30 reviews

Prefer Restylane for under eye hollowing

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I think that a filler procedure is ideal for the circumstance described. The loss of volume (reduction of fat) after blepharoplasty creates hollowing under the eyes. This is best addressed with a filler agent that can "volumize" the hollow area. I agree with comments noted by other physicians that this is safe and effective but highly dependent on the skill of the person performing the procedure. Another option for longer-term results is fat injection.

Guy Lin, MD
Manhattan Facial Plastic Surgeon

Great caution in injections around the eyes

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Great caution must be exercised in this area when injecting any filler. I will only inject a reversible filler in this area ie Juviderm or Restylane. Both can be reversed with another injection. The incidence of complications or undesirable results in this area are at least 10% by most reports so again make sure the person injecting in this area is extremely experienced. To me this requires a facial or plastic surgeon or eye plastic someone who has an understanding of the anatomy in this area and can deal with problems should they occur.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.