Tear Troughs injections for 30 yo male. - How close to the bone & inner corner of eyelid, can Restylane injections go? (photos)

I am 30 year-old male with tear trough at lower eyelids, like dark circles. Last year, I developed some small bags that make the dark circles worse. I have no excess skin. I visited some plastic surgeons, and I was offered Restylane injections or fat reposition Is this correct, am I a potential candidate for both solutions ? How close to the bone and inner corner of eyelid can Restylane injections go?

Doctor Answers 6


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Based on the pictures posted, you are a candidate for either a filler or fat transfer to the tear trough. You do not have excess fat bags in the lower lid for redistribution of your fat bags. Careful about doing any blepharoplasty type of procedure, you show significant white of the eye in the lower lid which predisposes you to more lower lid retraction

Baltimore Plastic Surgeon

Tear Troughs, Under Eye Bags & Dark Circles Are Easily Treated Nonsurgically With Fillers

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Fortunately, these days, tear troughs, bags and dark circles under the eyes can be easily treated nonsurgically in a matter of minutes through the use of fillers, such as Belotero Balance. What's more, it has become increasingly evident that earlier intervention may actually forestall or even reverse the aging process, which, over time, may translate into less frequent need for treatments and less material used per treatment session for maintenance. For more detailed information on nonsurgical rejuvenation of the eye unit, check out the archives of Realself.com. And, of course, it should go without saying  that it is strongly advised to seek consultation and treatment by a board certified core aesthetic physician with extensive experience and expertise in treating this very delicate and important aesthetic unit..  

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Tear Troughs injections for 30 yo male. - How close to the bone & inner corner of eyelid, can Restylane injections go?

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I use Belotero-Balance over Restylane injections to avoid a possible Tyndall effect. I layer the HA filler deep to superficial... 

Dark undereye circles

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Based on the photos you provided, you would do very well with filler injections. Restylane and Beletero are both appropropiate and would give you good results. Even though the inner eye corner cannnot be directly injected, you can get a good correction in this area as the filler can be massaged into place from an injection farther away. Filler is generally placed over the bone more laterally, and then, as the cannula moves closer to the corner of the eye, the filler is placed slightly higher.

Sheryl D. Clark, MD
New York Dermatologist
4.7 out of 5 stars 10 reviews

Restylane for Tear Troughs

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Thank you for the pictures and your question. For younger patients, I generally recommend starting with fillers before pursuing surgery (such as fat repositioning -- a type of lower eyelid surgery).  Then, if you have had a few filler treatments and like the effect, surgery can be a good option.  Filler injections for the tear troughs are generally placed below the skin and eyelid muscle, close to the bone. This helps to limit any lumpiness and color change of the skin. The corner of the eye is generally avoided, so as not to injure the tear ducts.

Dark under eye circles or tear trough injections

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Based on these pics I think you will do better with Restylane or Belotero than fat given your thin skin.  These can be injected very close to the corners and you can get very nice results but be aware of a few things:

1) Bruising can be significant and can last a few days to a few weeks.  
2) This is an advance technique and one that only a handful of plastic surgeons do well

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 119 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.