Restylane or Juvederm for Genetic Tear Trough Deformity or Hollowness?

I’m 24 years old and always have had deep hollowness under my eyes (safe to assume it’s genetic). I’m seeking fillers and have found an ophthalmic surgeon in Los Angeles, but want more options. He asking for $1,500 for 1 syringe, is this average? I’m curious whether it will help with my situation or will it make it bumpy and wrinkly when I smile. Also, should I get Restylane or Juvederm? I had Juvederm in my lips roughly 2 years ago and it went well. I’m extremely scared. Any suggestions/advice will be appreciated.

Doctor Answers 8

Get Restylane for Tear Trough Deformity

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Your best bet is to use Restylane under the eyes. Juvederm is a great product for elsewhere on your face. However lower eyelids swell very easily and Restylane is less likely to swell.

The good news about Restylane (or Juvederm) treatments is that they are reversible. If you are unhappy with the treatment after a few weeks, the filler can be completely dissolved with a simple injection of Hyaluronidase.

Hope this is helpful.

Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 26 reviews

It is always possible to find someone to do anything for less

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The placement of filler in the under eye area is an art form and not so much a treatment technique. The price you were quoted is about right for the high end Beverly Hills and West Los Angeles practices with the most experienced injectors.

For this type of cost, you should expect a detailed service by the actual surgeon rather than a nurse or other type of injector. This type of treatment places an absolute premium on a detailed surgical knowledge of the lower eyelid midface anatomy. For this reason, many dermatologists are not comfortable placing this treatment. Also you may in fact need more than one syringe of filler to treated the under eye area. The longevity of the Restylane in this area is excellent and can last up to 2 years so that a well done service even on the more expensive side can be a very good value.

With regard to Restylane vs. Juvederm, these are both hyaluronic acid fillers. However, the "smoothness" of the Juvederm means that what was initially placed for under eye fill can settle into the top of the cheek creating unwanted fullness. This type of product drift is not seen with Restylane.
The good news is that if you go with cheap service and are not satisfied with the results, it can be correct using the enzyme hyaluronidase. Again this type of an adjustment needs to be done by a highly experienced injector.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fillers for under eye hollows

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Improving hollows under the eyes with filler is definitely an option. And a good option - patients do very well if there are hollows. Here is my advice:

1. Ask for before and after photos.
2. Ask how many syringes the physician thinks will be required. In my experience you usually do not need more than 1.
3. Realize that you will have bruising so plan for this procedure when you do not have any big events coming up.
4. Make sure the physician is board certified and injects a lot. Filling tear troughs is an advanced skill. You may want to consider a dermatologist in your area for a second opinion.
5. $1500 for one syringe seems a bit pricey - find out what this includes (is the physician only going to fill below the eyes or also put filler in the brow/upper lid area?)
6. Personally, I like Restylane in this area more than Juvederm - but that is just what I use.
Bottom line: Hollows fill very nicely, but again your result is really going to depend on the experience of your physician.

Kavita Mariwalla, MD
New York Dermatologic Surgeon

Do You recommend Restylane for tear troughs ?

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Restyane works very well for hollow tear troughs with great outcomes in experienced hands. Although the estimate you got seems on the higher end of prices, you are paying for experience and perhaps location. I am sure that you can find someone in LA who can do it for less than 1,000 dollars and who has (most importantly) the reputation and experience to give you a very nice outcome For that price (1500 - 2500), you can probaby get autologous fat transfer. .

Juvederm or Restylane for under eye hollows both work well

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I use Juvederm and Restylane and I think they're equally effectively for filling in under eye hollows or the tear trough deformity. Both products are clear, gel-like and made of hyaluronic acid, which is probably the filler with the greatest safety profile. Injections around the eyes of any filler should not be taken lightly. You must seek expert advice from a doctor. that performs a lot of fillers in this area. Artistic injecting technique proper deep area or plane is critical to avoid filler visibility and get a natural-looking outcome.

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.9 out of 5 stars 119 reviews

Options for fillers in the tear trough

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I would assume you are looking for a long-term solution. The HA fillers Restylane and Juvederm are both good choices for that area, but there is one thing to be careful of: if you have thin skin, you may see some bluish coloration even with the filler deep as it should be, especially toward the inner corner of the eye. I like Evolence for this area because it doesn't have the color issue, though I do use both Restylane and Juvederm there frequently. ($1500 for one syringe sounds a little on the high side.) Another option you may want to look into is fat transfer, which can be a permanent correction.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Tear Trough deformity fillers

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In addition to Restylane and Juvederm, I have had recent success with Evolence in this area and it seems to last longer.  But be careful and go to an experienced physician.  It should cost less than $1500.00 for two syringes!

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Restylane or Juvederm

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Filler in the tear trough area should be placed (carefully), deep to the orbicularis oculi muscle in that area. You can get a nice, natural result with Restylane, my filler of choice for the lower eyelid hollows. You could probably do much better than $1500 per syringe. I would check around.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

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.