Hereditary Hollow Lower Lids and Thin Skin. Is Restylane the Best Treatment?

I am a white female. Almost 22 yrs old. I have always had hollow eyes, but over the past 3 years, they have gotten worse. I had 1cc of Radiesse injections into the tear troughs in March of 2010. The Radiesse didn't even last 3 months. I have heard Radiesse is not recommended for that area anyway. I am considering Restylane at the end of this month. Is that my best option?

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11 Doctor Answers | Asked by TrueSouthernBelle

Doctor Answers (11)
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Restylane for lower eyelid hollowness

Restylane can help augment this area but I find less risk of lumpiness when it injected below the muscle rather than immediately under the skin. Many of the patients who are dissatisfied with their results and complain of lumpiness appear to have had Restylane, or Juvederm, injected superficially above the muscle. The thin skin here shows the lumpiness. see video

Best filler for under eye area might be fat

The problem with thin skin and a hollow area under the eyes is that the color of any filler might shown through. Any of the HA fillers such as Restyane or Juvederm can present a bluish color called the Tyndall effect, whereas Radiesse does not, so it may not have been a terrible choice. In my view the best answer is often fat injections, which can be permanent and look very natural if done skillfully.

Don't get Radiesse in the under eye area.

I have personal stopped using Radiesse. Some docs like it because it is less expensive than fillers like Perlane. However, the ability to adjust the service either shortly after placement or long after the treatment is only possible with the hyaluronic acid fillers like Restylane, Perlane, and Juevederm. For the under eye hollow, Restylane has proven to be an idea filler. However, this service is an art form. Not every injector can handle treatment in this... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Lower lid hollows

Restylane is a great filler for the nasojaugal groove of the lower lid hollows as you mentioned. I would not put radiesse there myself.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Radiesse versus Restylane in lower eyelid area

I prefer Restylane over Radiesse for many reasons. However, in reading your question , it sounds as if you were disappointed in the duration of effect for the Radiesse you received. Regardless, in terms of duration only, more often than not Radiesse lasts longer.

Steven Hacker, MD

3 reviews

West Palm Beach Dermatologic Surgeon

Restylane and other HA fillers can improve undereye hollowness

A hollow lower lid can create shadowing and darkness leading to a tired look. Injecting a hyaluronic acid filler such as Restylane can do wonders toward improving that hollow look. The filler must be injected at the orbital rim and placed deeply, slipped under the orbicularis muscle. Restylane can be expected to last 6-9 months.

Lower eyelid hollows

The Radiesse should have lasted longer! Having said that, Restylane is the best nonsurgical option for lower eyelid hollows for many reasons. The lower eyelid skin is thin and so need to put something there that won't show. Moreover, Restylane is reversible if there are any problems. You are also young to have surgery. Good luck. Dr T

Filler treatment of under eye hollows (tear troughs)

My approach to treating under eye hollows depends on the individual patient. For patients with mild hollows I often use Restylane, as in my experience it more forgiving (produces fewer lumps) than Juvederm. For patients that have lost a lot of volume in the high cheeks, in addition to the hollows, I often inject a deep foundation of Radiesse or Perlane, and later add more volume with Restylane on top of that foundation. The use of these fillers in this area is "Off... more

Hereditary Hollow Lower Lids and Thin Skin

This is a great question! The tear trough hollows are a very tedious areas to treat correctly and even harder to obtain GGREAT results. I recommend first try Restylane injections at a very low dose deeper into the tissues. Followede by a week check up to see if more is needed. Than wait until the Restylane resorbs, usually within in 3 months. If the patient is happy, I will either continue with the Restylane protocol or use a Selphyle PRFM injection as a more permament solutions. This is... more

More than one Option

Tear troughs can be tricky. Many filler options may be used in addition to fat, which has been very well studied in that area. The problem with fat is that it requires a skilled surgeon to prevent any problems especially rippling and lumpiness in the skin. Radiesse should be avoided since it can harden up and will look unnatural there. Radiesse is great however, since its white and prevents the Tyndal effect or the blue colored hue that occurs with the injection of HA fillers in the area.... more

Restylane versus Radiesse in hollow under eyes

I am surprised that Radiesse lasted only 3 months after injection. Do you have before and after photos to prove to yourself that this is so? Both Radiesse and Restylane should last longer than 3 months. Restylane at least 6 months and Radiesse 1 year, although the improvement at 8 months may not be as noticeable as that at 3 monyhs. The best technique for injecting in this area is over the periosteum (under the muscle) with a slow, gentle sliding movement of the needle,... more