Can Restylane work for puffy eyes?

Restylane and other similar Hyaluronic Acid (HA) products can work for puffy lower eyelids, but how it works is both different from its use to fill other wrinkles and lines in the face, and similar in other respects.

When used to fill laugh lines and facial wrinkles, or to plump the lips, Restylane is injected into an area (wrinkle or crease) that is either "depressed" or lower in height than the surrounding area, or into an area that is "deficient" in volume, as in the case of thin lips.

With puffy lower eyelids, the causative problem is generally not the bulging fat pocket of the lower eyelid, but rather the retraction of the cheek downwards as a result of gravity. This causes a triple contour of the lower eyelid and cheek, with a hollow-appearing area along the bony orbital rim between the puffy lower eyelid and the normal cheek. Previously, fat removal from the lower eyelid was recommended to treat this condition, but often the results were disappointing.

Restylane is injected into the trough under the puffy lower eyelid fat and above the cheek in order to fill the hollow. By adding volume to this area, the dark circle can be hidden by raising it to the height of the surrounding areas, creating a highlight in place of a shadow.

The potential side-effects include lumps or irregularities in the injection areas, translucent "bubbles" under the skin in the injection area if the Restylane or HA material is injected too superficially, and other exceedingly rare complications including blindness.

By adding Restylane or other HA to the dark circle, you can subtract the circle, and create a highlight in place of a shadow. This is subtraction by addition.