Restylane Vs. Fat Grafting for Under Eye Hollows?

I'm of East Indian origin and I have hereditary dark under eye circles. I have very thin skin under my eyes and a deep depressions in the inner cornes of my eyes and wrinkles. I'm trying to decide between getting Restylane injections to correct the hollowness or get Fat Grafting. I've read some pretty scary stories about both procedures and I'm not sure which is safer. Thank you

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dark circles comparison depression fat graft pros and cons

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6 Doctor Answers | Asked by sahara in Toronto, ON

Doctor Answers (6)
Community Comments (1)

Restylane is temporary and fat injections can last years

Restylane will last about 6-9 months but can improve this area. Fat injections can last 8-10 or more years. You are one the right track though. You need volume in this area and that's the best way to improve this area. One thing to realize is that restylane will go away and can also be taken out earlier if you wish through enzyme injections. This can be reassuring. Fat injections are more permanent and is a little harder to get rid of if you don't like the volume but can be done through... more

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

Fat injection vs Restylane

Fat injection, even in the best of hands, has the chance for lumpiness. This lumpiness can be difficult to correct. Especially in young patients we prefer Prevelle or Restylane.

Filler vs. Fat injections

Restylane or Juvederm, both hyaluronic acids, are commonly used, off-label (not FDA approved for this use, but doctors may legally perform the procedure) for this purpose. Fat injections may give you a good result but, there are different ways that both of these fillers are done by different doctors. Some inject over the muscle, and there may be larger chance of visible bumps. The nice thing about Restylane or Juvederm is that if there is too much filler injected, it can be dissolved by... more

Options for lower eyelid treatment

Fat grafting involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed. In regards to safety for under eye correction, there is a greater possibility of irregularity of result with fat transfer than with fillers such as Restylane. That is because it is difficult to place very tiny strands of fat under the very thin skin in the tear trough area, and therefore slight lumpiness is sometimes seen and... more

Restylane vs fat for under the eyes

Restylane is temporary but is more forgiving in that it can be molded. Fat is permanent but may cause more lumps that are more difficult to deal with thatn restylane.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Restylane

Although you may have heard scary things about both procedures the incidence of them happening is quite low. That being said the potential bad things that can happen from fillers are generally less severe and usually reversible when compared to fat transfer. You are young and your lower lid contour is relatively good. I would recommend beginning with filler. You don't burn any bridges and I beleive you will be pleased with your result.

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Comments (1)

Dr. J. Ditesheim 23 Sep 2012

It may be possible to improve the dark shadows with structural fat grafting. That is a relatively new procedure where very small droplets of fat (0.1cc) are injected very precisely into either the area under the eyelid muscle or on deeper on the surface of the bony rim ( inferior orbital rim). It really depends on the facial bone structure of your face. If the cheek bones can be added to with volume this can improve the hollows, if the cheeks are already strong or prominent, then adding fat or any other filler can really be a bad idea. Another new option is Belotero, a new filler from switzerland, marketed by Merzin the US. It is designed for injection into the skin not below the skin as is the case with other fillers. This would be an off label use in the US. The most important piece of information is to consult with a plastic surgeon who can look at your face and understand what treatment will produce a more favorable predictable result.

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