What is the best injectable filler for undereye hollows?

Hi Hot Nani in Hotlanta,
I went to medical school in Atlanta, so I will try to answer your question with Emory pride. I have used both Restylane and Juviderm for facial filling; they are both very good hyaluronic acid filler products.
Under the eyelid in the tear trough depression area, I have again used both fillers. I have found that Restylane is most dependable in that what I put in won't go "crazy" with puffiness and swelling. I have not had any problems at all with Restylane in this area. On the other hand (or tear trough hollow) though I have treated a few patients with Juviderm in this area, after my second patient had swelling and edema (with identical technique and under correcting) I have stopped using Juviderm there. Most of the patients looked great, but I found Juviderm to be unpredictable in this sensitive area. Many other facial plastic surgeons have shared similar experiences with me. I am not a speaker or representative for either company. Make sure that you choose your experienced physician carefully for injections in this area.
Once successfully in place, Restylane in this area has impressed me with it's longevity of up to and many times longer that one year.
William Silver, MD in Atlanta is a very well respected facial plastic surgeon.
Be well.
Dr. P

Hi @Nani! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area. I commonly use Juvederm and Restylane. Best of luck to you!

I almost always use Belotero in that area. The reason is that other hyaluronic acid filers (Juvéderm, Restylane, Voluma etc) can leave a blue discoloration when placed close to the skin or underneath thin skin (ex: under eyes). This is called the Tyndall effect and is not desirable. In my experience, Belotero does not cause this blue discoloration. Additionally being a lighter molecular weight filler, Belotero is less likely to leave lumps or bumps under the thin under eye skin.

Hello and thank you for your question. I often treat this area with Restylane, although Juvederm and a few other select fillers also work well in the tear troughs. More important than the specific filler used is the method in which it is delivered. In my practice we use a blunt-tipped cannula, rather than a needle, to treat this area. The cannula tends to minimize bruising after treatment and create the smoothest possible result. Make sure you choose a very experienced, board-certified injector to ensure the best possible outcome.

My preferred filler for the area around the eye is restylane L. This can be used to treat the under and sometimes the upper eye hollow. In expert hands, it is safe and effective. I almost always use blunt cannulas to minimize the chance of intravascular injection. This should only be done by a board certified, experienced injector. 

For my practice I prefer the Restylane products: however most hyaluronic
acid fillers should provide a nice result depending on the injector. Since some fillers may appear through the
skin causing a bluish or bruised look, I would not
recommend Voluma, Restylane Lyft or Radiesse.  Best