Tomorrow doing a Restylane filler to tear trough. Is this treatment right for me? (Photo)

Please help me understand if this is right for me.

Doctor Answers 11

Restylane filler to tear trough. Is this treatment right for me?

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. From the photos, your cheeks are very flat anteriorly (in the front).  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissue layers need to be adjusted by what technique and amount.

 Dermal fillers to shape the cheeks would be a great place to start as this alone can feminize the entire face. In order for that to occur, the dermal filler needs to be placed in the front of the cheeks which will create a full round cheek and thereby a feminine, heart shaped face. If however, the dermal filler is placed to the outside of the cheek this broadens and widens the face which is a relatively masculinizing effect and one that will "not" create a more feminine shaped face.  In contrast, dermal filler to the tear troughs will not feminize the face.

Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Use of restylane filler for tear trough improvement

Although any of the hyaluronic acid fillers are reasonable options for the tear trough, because this area is so fickle and the skin so thin, my preference is restylane, restylane fine lines, or redensity-II for the tear troughs. Even more important than choosing the right filler, is having it placed properly and safely by a highly trained and experienced physician (e.g. dermatologist).

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
4.9 out of 5 stars 44 reviews

Tear trough restoration

Restylane is the absolute best filler for the tear trough done by a board certified facial plastic surgeon or board certified dermatologist who has expert and additional training. You should have a wonderful result.

Lesley Rabach, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Restylane and other fillers for the tear trough

Restylane and other hyaluronic acid fillers are a great option to reduce the hollowness under the eye.  Keep in mind that you should only see an experienced board-certified physicians for these treatments as the under eye area is a complicated area often performed incorrectly leading to swelling or visible bumps.  Best of luck.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Restylane for Tear Troughs

It appears as if you are a good candidate for Restylane injections in your tear troughs. You have hollowing under your eyelids without excess skin or heavy fat bags. Restylane can be safely injected in that area when done properly. If injected too superficially it can cause a bluish appearance known as Tyndall. Some people can have bruising and swelling which is usually temporary. In some cases patients don't like the results and it can be reversed with an injection of Hyalurorindase. I prefer to use a cannula to inject to reduce the risk of bruising and other potential complications.

David Schlessinger, MD
Long Island Oculoplastic Surgeon
4.7 out of 5 stars 15 reviews

Belotero Balance & Teosyal Redensity II Work Well For Treating Tear Troughs--But Perhaps Treat Cheeks First

First to directly answer your question, while plain Restylane has been used for the undereye region, to avoid lumps and bumps and to diminish somewhat the tendency for that problem and for the development of the unwanted bluish Tyndall Effect, many injectors were diluting the Restylane in the past. Nowadays, the company has made a more appropriate product known as Restylane Silk. In my Upper East Side Manhattan office, Belotero Balance, however, is my personal preference for this very delicate region. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I typically opt for Teosyal Redensity II).

Having said this, I would like to offer an additional comment for your consideration. From the photos there appears to be flattening of the cheeks in the cheekbone areas. I would suggest that nonsurgically enhancing the cheeks in this region with a volumizing filler, such as Voluma XC (NY) or Stylage XXL (Israel) would not only improve the overall contour of the face, but would likely secondarily improve the underye regions to the point that they would either need much less material for the tear troughs or perhaps even no treatment at all.

You would do well to make sure that you consult with a board certified aesthetic physician, and make sure to insist upon seeing his/her before and after photos of both nonsurgical cheek and undereye region rejuvenation before agreeing to proceed. Best of luck.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Restyle safe under eye tear troughs

You are probably a very good candidate as you are young enough so not too much fat prolapse, and you have good skin for support and colour. The success will be partly dependent on how and where the Restylane is placed. In this area I use Restylane with Lidocaine and limit to 1 ml in the fist instance, injecting via single port entry with a very fine canula. In that way I can reach the upper cheek to eyelid auction where flatness (I call this triangular atrophy) and then drizzle a little Resylane up into the tear troughs. Less is more - more cautious, more natural, more sensible. Every practitioner is different and has their own well tried and tested manner of injecting. Good luck today!

Jane Olver, MBBS, FRCS
London Oculoplastic Surgeon
4.2 out of 5 stars 5 reviews

Perfect patient for fillers

Thanks for sharing your photos with us. You appear to be young, don't have eye bags yet, but do have some tear trough hollowing. 

You are a perfect patient for restylane to the tear troughs!!

Make sure that you're facial plastic surgeon is experienced in injecting tear troughs and be ready for a little bit of bruising over the weekend. 

Enjoy the results! Good Luck!

Dr. Robb

Philip K. Robb Jr., MD
Evans Physician
5.0 out of 5 stars 7 reviews

To appear to be a good candidate for tear trough filler

 You appear to have moderate hollows, and no significant fat bags. That would make you a good candidate. Check out this video!

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 169 reviews

Tear trough and filler

You are a good candidate for filler in this area, but be sure you are seeing a qualified dermatologist or plastic surgeon

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 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.