Restylane or Juvederm Injection Safe and Effective for Under Eyes?

Is it safe and effective to have Restylane or Juvederm injected under the eyes for hollowness? If so, which is better? I had a lower blepharoplasty 8 years ago and I'm very hollow under the eyes. I am 48 years old and I have an appointment for a consultation and possible treatment this coming week, but I am apprehensive about the actual injection.

Doctor Answers 18

Restylane is safe and effective for under eyes

Dear Hopefulhollow,

RESTYLANE. Hands down.

Juvederm is a great filler but causes more swelling and is best not used along the periorbital area.

For best results, I would insist on getting the injections from an experienced DOCTOR (not a nurse or other injector). As a plastic surgeon, I COULD smugly tell you that we are THE best. But that would not be true.

I would though pick a GOOD ENT (facial plastics) or Dermatologist as easily but make sure they can deliver what you want and will be personally responsible for the result.

Good Luck.

Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Yes, it can be done, but it is a very tough procedure and should only be done by an expert

When I say expert, I mean it. If you go to the medispa down the street, you are most likely going to be very unhappy. It can have real problems (read some of the RealSelf questions on this subject if you doubt that) if done improperly.

Even if it is done properly, it sometimes doesn't work all that great as that area can be scarred from the initial procedure and the anatomy of the area can be 'off'. Good luck whatever you do!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 reviews

Restylane and Tear Trough

Of all the areas in which we place fillers, this is potentially the highest impact region of the face. The results of a well-done augmentation of the lower lid complex can have major rejuvenating effects. However, of all the areas, this is the one in which you need to find an injector with expertise and experience in injecting this area. The potential complications can range from minor irregularities to serious injury to the anatomy around the eye. In well-trained hands, the risks are very minor. Restylane and Juvederm are probably the two safest substances to inject in this region. Web reference:

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.6 out of 5 stars 114 reviews

Prefer Restylane for under eye hollowing

I think that a filler procedure is ideal for the circumstance described. The loss of volume (reduction of fat) after blepharoplasty creates hollowing under the eyes. This is best addressed with a filler agent that can "volumize" the hollow area. I agree with comments noted by other physicians that this is safe and effective but highly dependent on the skill of the person performing the procedure. Another option for longer-term results is fat injection.

Guy Lin, MD
Manhattan Facial Plastic Surgeon

Great caution in injections around the eyes

Great caution must be exercised in this area when injecting any filler. I will only inject a reversible filler in this area ie Juviderm or Restylane. Both can be reversed with another injection. The incidence of complications or undesirable results in this area are at least 10% by most reports so again make sure the person injecting in this area is extremely experienced. To me this requires a facial or plastic surgeon or eye plastic someone who has an understanding of the anatomy in this area and can deal with problems should they occur.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.9 out of 5 stars 18 reviews

Prefer Restylane

Filler injections are effective and safe under the eyes. This is especially true in the tear trough area. However, this is one area that less is better so be sure not to "push" your injector to place more material than is necessary. You can find pictures on RealSelf displaying examples when too much substance was placed in this area.

My preference is Restylane since it does not seem to migrate.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Restylane for hollow tear troughs

Restylane is the filler of choice for the tear trough area.  Please have treatment with a board certified dermatologist, plastic, oculoplastic or facial plastic surgeon who has experience in treating this area.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Eyelid surgery, Restylane, Peri-orbital hollows, hollow under eyes, tired eyes

You ask a very good question- the under eye area needs special attention and care. The hollow contributes to a tired appearance. With blepharoplasty the area under the eye must be filled in or the eyes may look more tired in the short time when the surgical swelling has resolved.

Restylane can be used to correct the hollow very nicely. As an alternative the hollow can be fat grafted at the time of surgery or if not then- at a later date. Fat grafting gives a permanent result to the correction of the hollow.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 115 reviews

Filler along the lower eye

Placing filler material such as restylane and juvederm along the lower lid can be done. There is a slight risk of blindnes that has been reported with this technique although it is extremely rare.  Go to an experienced injector.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Restylane Injections Under the Eyes to Correct Hollowness

Hi Hopeful,

I, and many others now only use Restylane to fill lower eyelid hollowness because of experience with too much swelling under the eyes with Juvederm in one of my patients, and in many patients injected elsewhere.

The safety of the injection in this area is related to the experience and skill of the injecting physician. It is a very delicate and unforgiving area so choose your injecting physician most carefully.

When performed properly, the results are excellent.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 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.