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"One of the Best" Cosmetic Dermatologists Wants to Inject Radiesse and Sculptra Under Eyes - Thoughts?

i just went to "one of the best" cosmetic dermatologists in dallas to explore getting restylane injected for my tear troughs. Instead, she wants to inject Radiesse at the bottom of the "U" of the trough. If I like the effect, in six months, she will inject around the lower orbital bone with Sculptra. I'm 60 yrs old and I've read that neither of these are supposed to be used around the eye. Thoughts?

Doctor Answers (9)

Radiesse and Sculptra Under Eyes?

+1

Hi CautiousLady.  We would not recommend injecting Radiesse of Sculptra under the eyes. 

Regardless of the skill if your injector, there is a natural cost/benefit analysis that any injector will use in determining the right area of the face for different injection products.  Because HA (Hyaluronic Acid) based products last a long time under the eyes (9-12 months) and because they are easily reversible in this very sensitive area of the face, we find the risk of using a longer lasting filler like Radiesse (that cannot be reversed)under the eyes greater than the potential benefit.  We just don't see the point.  Good luck.


Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Both radiesse and sculptra can be injected into the periorbital area

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Both radiesse and sculptra can be injected into the periorbital area. But, it is very important to go to a doctor who is very well trained and specializes in the eye area. Ideally you should see an oculofacial plastic surgeon with a lot of experience in injecting Radiesse and Sculptra around the eyes. There is a much higher chance of getting bumps and complications in these areas if you are not being injected by a specialist.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Radiesse is my preferred filler for the tear troughs

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Most of the fillers that are available in the United States can be use to treat the tear troughs.  Each filler has advantages and disadvantages and, as a result, different physicians will favor certain fillers for the tear troughs.  The advantage to using the hyaluronic acid fillers (Restylane, Juvederm) is that they are reversable if the results are unsatisfactory.  I think a disadvantage to these fillers is that they are clear and can sometimes cause the dark circles beneath the eyes to get darker.  Since Radiesss is beige in color, it will not darken the tear troughs and, for this reason, is my preferred filler in this area. 

Jonathan Sonne, MD
Naples Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

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Tear trough fillers

+1

As we are correcting cosmetic situations, it would be wise to allow for improvement of negative side effects by conventional treatment. If there is a product such as Radiesse or Sculptra or Fat Injections that are used for the tear trough and the results are not appreciated, it will be hard to reduce these side effects.  Hyaluronic acids, such as Restylane and Juvederm,  can be dissolved with hyaluronidase making them more favorable candidates for fillers of this area.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Both Radiesse and HA's work great in tear troughs

+1

Which filler works best depends on the area, patient and the comfort level of the physician level using it.  If a physician has little or no experience with a filler he may warn you against using it but that doesn't mean it shouldn't be used.  Some fillers should not be used in certain areas because of problems, such as Radiesse and Sculptra causing lumps when injected into lips, but in the right patient Radiesse can be a great filler under the eyes.  In fact, I prefer it to Restylane and Juvederm in some patients with dark circles because the white color of Radiesse can lighten up this darkness while Restylane and Juvederm can sometimes make them appear darker because of their blue hue. 

In experienced hands, any of these fillers can do a good job.  If however the skin and muscle are very thin in this area it is sometimes hard to put any of these fillers in without them showing through the skin.  In the bottom of the "U" of the trough there should be plenty of skin and muscle however and Radiesse is usually my favorite filler as this area borders on the cheek and Radiesse is a much better filler for plumping cheeks.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
5.0 out of 5 stars 163 reviews

Fillers for the tear trough

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I would be very cautious here.  As I have used HA in the past in this area and have seen patients having had fat injected in this area and are now very unhappy, I would not consider doing anything else but HA (restylane).  There is no reason to.  HA work well with minimal down time and minimal chance of showing when injected by right surgeon.

Radiesse is very thick and can show, even in the nasolabial fold if injected improperly.  I would do my research, go to a plastic surgeon that your friend or family knows and is happy with.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 31 reviews

Do NOT have Radiesse or Sculptra in the Lower Lid / Tear Trough Area

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Regarding: " One of the Best" Cosmetic Dermatologists Wants to Inject Radiesse and Sculptra Under Eyes - Thoughts?
i just went to "one of the best" cosmetic dermatologists in dallas to explore getting restylane injected for my tear troughs. Instead, she wants to inject Radiesse at the bottom of the "U" of the trough. If I like the effect, in six months, she will inject around the lower orbital bone with Sculptra. I'm 60 yrs old and I've read that neither of these are supposed to be used around the eye. Thoughts
?"

Two comments.

The main reason why the hollowness of the Tear Trough is so striking is because the sagging of the cheek and the extreme thinness of the skin unveils the lower rim of the eye socket. This area in extremely intolerant for most fillers. Any pigmentation, any clumping would be readily seen and felt. For this reason fat grafting is unreliable in this area. When it takes, it does well BUT when it does not live, the lumps of fat are visible across the room.

Radiesse is a white, pasty filler made up of sea coral dust. Not only can it be visible through the skin in this location but its tendency to form lumps makes it a poor filler in this area (but a great filler along the nose to mouth folds). Sculptra tends to clump as well and in my opinion is best used elsewhere in the face.

Restylane IS THE BEST choice for this area. Sorry Dr. Best.

Second comment. It always amuses me when people refer to physicians as "Best". I would suggest that unless we could put 50 operating tables, side by side, operating on nearly identical patients and had our diagnosis, operative techniques and result judged critically, no one can truthfully be declared "best". There ARE surgeons who are more wel known than others. Those are based on professional reputations but these days much more on Public Relations consultants and media exposure.

You will be far better served by picking a surgeon recommended by family and friends who has won your confidence.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

Tear trough and lower lid injectable treatments

+1

Dear Cautiouslady,

Having used Restylane in the tear trough and lower eyelid area for over four years, I hardly find a reason to even look for another filler for this area.  

Restylane's safety track record, and phenomenal results with minimal long-term swelling have made it the preferred injectable choice for this area in my practice.  As a cautious doctor, I can tell you that I seldom would use a filler that is irreversible in such a sensitive and tricky area.  

I would advise that you thoroughly discuss the pros and cons of all of the different choices that your dermatologist offers to treat this area.

I hope this helps,

Dr. Torkian - Lasky Clinic, Beverly Hills

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 8 reviews

Fillers around the eyes

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The use of these fillers would be off label for the orbital indications- BUT they are commonly used in these areas with wonderful results- when in the right hands. The decision to use these fillers in particular was likely based on experience and your skin texture/amount of volume needed. Speak to your physician injector about your concerns and what treatment you are comfortable getting.

Purvisha Patel, MD
Germantown Dermatologist
5.0 out of 5 stars 3 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.