Ask a doctor

Can Restylane Injections Damage my Eyes?

I will be having Restylane injected for my under eye hollows. I am so afraid. I worry about retinal occulusion, and blindness. I also worry about long term effects. Can you give me your opinion about the procedure under the eyes? Thank you.

Doctor Answers 23

Don't have Restylane injection for under eye hollows

Although many doctors use Restylane, Juvederm and other soft tissue fillers to correct under eye hollows, I do not.

Although retinal artery occlusion and blindness is very rare and unlikely (2 cases in the literature), visible lumps under the skin and downward migration of the filler is very common.

The eyelid skin is so thin that the filler is often visible as grey lumps.

More commonly, filler injections for under eye hollows, after 6 months are pushed downward by gravity and the action of the eyelid muscle, and the rim of filler is seen on the rim of the orbital bone beneath the dark eye hollow-this actually makes the hollow look worse.

Many, many doctors disagree with me, but i have seen these prob;lems in patients who have had their filler injections iunde rthe eye done by the 'worlds experts' at filler injection.

If you want to do this be certain you see a widely recognized expert board certified plastic surgeon and have him/her show you before and long term 96 months or longer0 results of his/her patients that they have injected.

In my opinion, the proper procedure to correct under eye hollows is surgical fat grafting--it is permanent and smooth-see reference below.

Have a question? Ask a doctor

Blindness from Restylane is highly unlikely

Restylane injections are very safe when performed by someone who has alot of experience working around the eyes, such as an oculoplastic surgeon. It's true that if the material is injected into a blood vessel, this can cause retinal artery occlusion and blindness. I have seen one case described in the medical literature. I always withdraw the needle as I'm injecting so as not to push filler into a vessel. Again, make sure you go to someone experience with injections of Restylane around the eyes and you'll be just fine.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 34 reviews


Restylane and other hyaluronic acid derivatives are an effective and time proven substance for correcting under eye hollowing (tear troughs).  The usual side effects are bruising, redness, and tenderness that subside quickly. Lumpiness or a blue-tinge to the eyelid skin (Tyndall effect) are other side effects resulting from misplacement of the filler substance.

In extremely rare instances the injectable filler can be inadvertently placed into a vein or artery resulting in a stroke to the retina or optic nerve and permanent blindness. Once again this is an exceedingly rare side effect of treatment.

Adam J. Cohen, MD
Skokie Oculoplastic Surgeon
3.5 out of 5 stars 13 reviews

Experience counts

I really love doing hyaluronic treatments under the eyes. I say this even though I am a facial plastic surgeon who does eyelid surgery every week! I started doing the injections about 4 years ago and have even had the treatment myself about 2 years ago. It is amazing as the results can easily last 2-3 years( if not longer). Although reports of blindness are present in the literature I would recommend that you choose your doctor carefully and consider the background, training and experience to lower the risk of any possible untoward outcomes.

Robert. Gray, MD, FACS

Robert F. Gray, MD, FACS
Bay Area Facial Plastic Surgeon
3.0 out of 5 stars 12 reviews

Can Restylane Injections Damage my Eye

There have been reports of blindness from injection of dermal fillers around the eyes in very rare cases .  That is why it is important to see a board certified Plastic Surgeon who has experience with these injections.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
5.0 out of 5 stars 46 reviews

Be careful!

As they say “anything can happen”, although it seems an unfortunate expression for your question. My answer is that there will always be risks but if you have a qualified doctor who is aware of not only the anatomy of the face but the eye as well, your risk of damage will decrease. It comes down to who you choose to have your procedure done. My advice, choose wisely!

Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.5 out of 5 stars 28 reviews

Restylane under the eyes must be done carefully.

You asked if there was a risk of damage to your vision. I must say yes, there are more risks associated with under eye filler injection than with the more straightforward nasolabial (melolabial) fold injections. 100% for sure only a board certified dermatologist or plastic surgeon experienced in surgical procedures around the eye should be performing this procedure. Many think they can do it, but many run into trouble, ranging from visible filler lumps that never go away, to occlusion of a blood vessel in the area. Be very cautious when selecting your physician.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 41 reviews

Can Restylane Injections Damage my Eyes?

Those are rare but possible side effects. I recommend that you find a very experienced doctor to inject for this area.

Suzanne Kilmer, MD
Sacramento Dermatologic Surgeon
4.5 out of 5 stars 4 reviews

Side Effects and Safety Concerns related to Restylane Injection for under eye hollows (tear troughs).

The treatment under the eyes with dermal fillers is an advanced technique, and can be plagued with complications. The first step is to choose the candidates appropriately. In the hands of an experienced and expert physician injector,retinal artery occlusion and blindness are extremely unlikely. Lumps under the skin and downward migration of product are greater concerns. Again, the skill of an experienced and expert physician injector can minimize these risks. I would generally recommend a patient to consult with three experienced and expert physician injectors to understand options before proceeding with the treatment.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 21 reviews

Restylane injections for under eye hollows.

Certain precautions greatly help in reducing the chance of the filler getting into blood vessels and thus leading to blindness, however rare this is claimed to be. These include retrograde injection, using a canula, and avoiding bolus injections among others. However, the chance of this complication can only be reduced and not done away with. An experienced injector (certified derm/ plastic surgeon) makes all the difference. 
Good luck!

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.