Ask a doctor

Is Restylane a Good Choice to Fill Hollowness in the Upper Lids?

I'm 57 years old and have upper lid hollowness. I've read that Restylane is effective and safe for filling in the upper lids. Since this is so close to the eyes, I would like to find someone with experience filling the upper lids with Restylane. The one oculoplastic surgeon I consulted does not use fillers for either the upper or lower lids. Is Restylane a good choice and how can I find someone experienced in injecting the upper lids?

Doctor Answers (11)

Restylane and eyelids

+2

Hello iSore - great question and I agree with most of the physicians who have responded  - the only product that I would use in the eyelid area is hyaluronic acid marketed as either Restylane or Juviderm - it is injected in my practice in very conservative amounts in the eye area and it can take 2-3 weeks for definitive correction.  I tend to inject a small amount, let the product set up shop and then add if necessary 10-14 days later for best correction.  It is reversible with a separate injection so the product is very safe.   A small amount of product goes a long way here to correct volume changes.  The new popularity of filling in these areas makes great sense as the volume here changes with aging and leads to a hollow tired appearance.  Returning volume creates a rested appearance - find a good injector who talks conservatively and has some good experience.


Hamptons Facial Plastic Surgeon
4.5 out of 5 stars 2 reviews

Hollowness of the upper eyelid

+2

deep upper eyelid creases and hollowness may be treated very cautiously by injections of restylane but in the upper eyelid it is not possible to inject in the septal crease deep to muscle over bone.  The injected material might be seen as lumpiness or excessive swelling.  Bruising is expected for a couple of weeks possibly after the treatment.  There can be very serious complications and fortunately these are very rare but your physician should discuss these with you in length.  Possibly and oculoplastic or plastic surgeon can perform a fat repositioning surgery to give you a long term correction for this condition.

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

Restylane for Upper Eyelids?

+2

Hi isore.  We commonly use Restylane for the lower lid, but do not use it for the upper lid.  

Especially if you have sagging or loose skin on the upper lid, we would recommend Blepharoplasty eye surgery to remove some of the skin.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

You might also like...

I would not use a filler in the upper lids

+2

Hyaluronic acid fillers, like Restylane, attract water to themselves.  What you may get as a result of injecting filler there is chronic swelling and sagging from the weight of the filler.

Eyelids are best treated with fractional laser resurfacing or blepharoplasty.

What can be done to improve the upper eyelid somewhat is to lift the brow with a combination of Botox and filler.

A photo would definitely be helpful for a better evaluation.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Filler for upper eyelids

+1
This is an excellent example of why your surgeon needs to be cross pollinated amongst all of the core four cosmetic specialties: dermatologic surgery, oculoplastic surgery, facial plastic surgery and plastic surgery. 

I just stumbled upon this question from a few years ago, and the most glaring thing about reading the answers is that they are all over the board.

The oculoplastic surgeons are saying "don't see a dermatologist about this," but the dermatologists are saying that they are the most competent with filler and know the most about it. This is why you want somebody who is competent in both of these fields and has trained with both. We get so isolated amongst these four different groups that we forget how much we overlap and how much we can learn from each other.

This makes me feel especially fortunate to have trained in a place where all four of these cosmetic specialties' fellows worked and trained together, trading ideas opinions and making everyone better in the process.

To answer your question, yes, Restylane and other fillers can be used in the upper lid with excellent results. Obviously, you just need to make sure that you are choosing the right person for this job. 

Cameron Chesnut, MD, FAAD
Spokane Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Restylane is Preferred

+1

Hi iSore,

Restylane can last a very long time in the upper eyelid area (1-3 years+.)  Much longer than other areas such as the lips and smile lines.  

The injector needs to be comfortable with the upper eyelid and brow anatomy.  There are several potential pockets which the filler can be injected into.  If it is injected into the wrong pocket, the filler will show when the person closes their eyes.  The upper eyelid is very complex, in that the upper eyelid opening and closing is like a "Roman Shade."  The upper eyelid skin fold under itself and actually can add volume to the brow area.  If the filler is injected too close to the upper eyelid crease, it will not look right.  

 

The best before and after photo to judge the skill of the injector, is actually the photo when the patient is looking downwards.  It should look very smooth.  A straight one photo can actually look pretty good, but when the patient looks down, the true skill of the injector is revealed.

 

Best,

Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Fillers Can Work Well For Upper Eyelid Hollows

+1

Upper Eyelid hollowness can be a very troublesome problem. Sometimes seen after aggressive blepharoplasty procedurres, and not uncommon in some very thin individuals, it may contribute to an unwanted "skeletal" sunken look to the region. 

I prefer the use of monophasic Juvederm XC, slightly diluted, to treat this area. I find Restylane, a biphasic product, to be a somewhat better bulking agent useful for a giving a more robust lift.   Juvederm, a monophasic product, has a smoother consistency and flows more smoothly when injected. In the thin, delicate upper eyelid region this can be used to advantage to recontour the sunken area without overbulking it. Only small amounts need to be injected evenly throughout the region to achieve the desired effect.

Bruising, while common in this location, can be minimized by the avoidance of blood "thinning" agents, such as aspirin or aspirin-containing products, NSAIDS; omega-3 fatty acid supplements; vitamin E; ginseng, ginko biloba, garlic  supplements, and St. John's Wort for a period of two weeks prior to injection, and alcohol intake for 24 hours beforehand. Icing, Arnica montana and bromelain may be used as part of post-treatment care to further minimize the bruising.  Proper and controlled injection technique is critical for the success of this technique. In general, both eyelids can be done within about ten minutes.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Restylane

+1

Restylane is a great filler for the hollowness of upper or lower eyelids.  It is safe, effective, and reversible. 

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Restylane best filler for upper and lower lids.

+1

Hi.

Of course it depends on your exact anatomy, but this often works very well, and is very long lasting (two years).

Technique is critical. Small amounts of Restylane are injected deeply, under the muscle and close to the bone.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Restylane is good for hollowness in the upper lids

+1

You really need to see a well-trained specialist. Restylane is good for hollowness in the upper lids, but ideally you need to see an oculofacial plastic surgeon who is well experienced in injecting Restylane in the thin eyelid skin. You can find someone experienced by looking up oculofacial plastic surgeons in the area or you can check the website of the makers of Restylane, Medicis Aesthetics. This site may tell you who the large injectors are in your area. Then you can look at their credentials to learn about their areas of specialty. You don’t want to go to a dermatologist to have Restylane injected in the eyelids. An ophthalmologist or oculofacial plastic surgeon is much more specialized in this delicate area of the face.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 22 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.