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Risks of Restylane on Upper Eyelids for Sunken Eyes

Hi there, I wore glasses until I was 26 y/o. For this reason, my eyes are quite sunken in my face. I was considering the idea of undergoing a treatment with Restylane to make my upper eyelids look fuller and less sunken. Could anyone explain to me any risks of this procedure or if there is anything better than this treatment? Many thanks.

Doctor Answers (13)

Restylane for Eyelid Rejuvenation

+4

Restylane is most commonly used under the eyes for eyelid rejuvenation. Restylane can also be injected below the eyebrow but above the eyelid to add fullness to the area. Due to the complex nature of the anatomy around the eyelid and the thinness of the skin, this area is best treate by a very experienced injector.


Long Island Oculoplastic Surgeon
3.5 out of 5 stars 4 reviews

Upper eyelid fullness with Restylane or Juvederm

+3

I have injected, off-label, Restylane and Juvederm into the outer aspect of the eybrow and slightly onto the preseptal upper eyelid but not the pretarsal lid. This helps augment volume that is lost with time and creates a lowering of the upper eyelid and hooding. It is done cautiously and with very low amounts. If it were injected into the upper eyelid skin in the lower aspect, it would have a higher chance of leaving you with uneveness, lumpiness, and prolonged swelling and may cause signficant bruising for a couple of weeks after treatment.

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

Bad idea

+3

Restylane and other fillers are great when used properly. The upper eyelids are not the place for filler. See an oculoplastic surgeon to evaluate your complaint and outline your options.

Mary Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 8 reviews

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Filler treatment for sunken eyes

+3

The placement of filler in the upper eyelids is very tricky and not commonly done, though not impossible. Placement of filler products or fat grafting often leads to more prolonged tissue swelling compared with treatment in other areas of the face. Additionally, the very thin tissue in this region makes irregularities or lumps a possibility.

Treatment to the eyelid/brow complex may improve the sunken appearance you're noting. I'd consult with a board certified physician with experience in treating this area to see what specific options may be best for you.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Risks of Restylane on Upper Eyelids for Sunken Eyes

+3

Hello,

I would not reccomend restylane or any other filler for upper lid issues.

It is not very forgiving in lid skin in general.  You should see a board certified dermatologist for a proper evaluation and options that can safely and predictably improve the problem

Dr. Malouf

Peter Malouf, DO
Dallas Dermatologist
5.0 out of 5 stars 71 reviews

Restylane for Upper Eye Lid?

+3

Hi London.  We would not suggest using a dermal filler like Restylane on the upper eyelid.  This is a very delicate area and could lead to serious complications if done imperfectly.

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

This treatment is still uncommon.

+3

Dear London

The anatomy of the upper eyelid is more complex than that for other parts of the face.  Additionally, the skin in the upper eyelid is quite thin.  Irregularities of the upper eyelid contour are more likely.  Also within the orbit but close to the skin is a relatively large vascular structure called the superior orbital vein.  There is a risk that an inexperienced injector could inadvertently inject filler into this vein.   While this type of therapeutic misadventure has not been reported, it remains a clinical possibility.  Because this vein communicates directly to the cavernous sinus at the base of the brain, the clinical outcome of such an event could be visual loss or stroke.  For this reason, experienced injectors typically lift the lid and inject the material along the orbital rim or alternatively treat very superficially and accept a certain level of skin irregularities.  Do to these considerations, there are limits to what can be accomplished with these type of treatments.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 15 reviews

Restylane for Upper Eyelids

+3

The skin on your upper eyelids is extremely thin so Restylane injections in this area would be far too risky and would be likely to cause visible bumps.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Upper eyelids and restylane

+3

Restylane is sometimes used along the lower eyelid crease and even for loss of volume in the upper eyelid/brow junction.  It may leave lumps as a coomplication.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Risks are lumpiness, overcorrection, and undercorrection.

+2

Hi London2011,

Injecting Restylane or any other injectable filler to the upper eyelid hollow is considered "off-label."  This means that the filler is not approved for this usage.  I firsted started treating upper eyelid hollowing in 2006 with fat grafting.  I began doing this as part of my upper eyelid surgery.  In addition, to removing a conservative amount of skin, I was also adding back fat into the upper eyelid hollow.  In 2008, I had a patient who did not want to have an upper eyelid surgery for fear of keloids.  Her main issue was really the hollowing.  However, I did not have a way to place the fat into the upper eyelid hollow.

 

I thought was possible to use Restylane in the same manner as I was surgically placing the fat, so I did a test session using Injectable saline.  This filled the area nicely.  A couple of weeks later, I followed that up with Restylane injections.  

 

Most patients will upper eyelid hollowing, have too much eyelid showing, in particular in the inner corner of the eye.  This can also be worsened with a doll's eye deformity, where there is so much hollowing of the upper eyelid, that it causes the upper eyelid skin to vacuum inside of the eye socket.  This can result in an older looking eye, especially when the person's eyes are closed.

 

The main risks, are lumpiness and overcorrection.  I believe there is a correct way to inject the upper eyelid filler, to simulate the configuration of the upper eyelid brow complex of youth.  The upper eyelid complex is 3 dimensional, but since the upper eyelid opens and closes, it is really 4 dimensional.  It should not only look normal when the eyelids are open, but it also needs to look normal when the eyes are closed.  If the injection is performed in the wrong pocket, it will look very lumpy when the eyes are closed, and you can see where the filler injection ends.  

I get emails from people all over the world.  I have seen photos of patients with improperly injected in the upper eyelid area.  They usually show a photo of their eyelids when they are closed, and the filler can be clearly seen.

If there is not enough filler injected, it is easy enough to add more.

Best,

Dr. Yang

New York Facial Plastic Surgeon

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