Can Juvederm fix my hollow under eyes? Or lower eyelid surgery? (photos)

I have hereditary hollow under eyes and smile lines from my mother and I've tried everything to get rid of them. Lately they've gotten darker and it's becoming harder to cover with makeup, the same goes for my smile lines. I'm wondering if juvederm will give me a smooth, flat under eye and plump my cheeks so my smile lines will not be visible. My biggest problem with them is that I'm only 20 and I look at least 25+ and my makeup tends to sink into my smile lines really bad.

Doctor Answers 22

Treatment for hollows under the eyes.

 Thank you for sharing your question. The best product to fill in your lower eyelid hollows is Restylane. Juvederm can cause a blue tint to the skin and excessive swelling. Restylane can also be layered with Silk to give added benefit. See an experienced injector who is specialized in eyelid procedures.
Good luck,

Cosmetic fillers like Restylane can treat under eye hollows, but they will require regular maintenance to sustain the look

Thank you for the question. You are asking if Juvederm would be useful for filling in the hollows visible with the photo you submitted. You explain you are 20-years-old and feel these are genetic or hereditary hollows, and the skin is a little crinkled, and you are having trouble covering this up with makeup. You say you feel at the age of 20, you already look 25.

I can give you some ideas based on how I approach patients like yourself in my practice, and help you make an informed decision. A little background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve practicing in Manhattan and Long Island for over 20 years and helping people with rejuvenating their eyes using a wide array of modalities, from minimally invasive such as skin products, to procedures such as laser, and surgery are things we do in our practice every day.

It is very important, that before you chose a particular product or solution, to define the problem and understand what the potential options entail. To begin, when someone who is young at 20 like yourself comes to our office, I always have to frame everything in terms of what is worth the time and investment. Helping these genetic issues will require some maintenance, so let’s begin with first the hereditary aspect of the relative hollowing. You look at the tear trough area and the area does look a little hollow, and the area of the eyelid-to-cheek can also look a little hollow. There may be some natural genetic hereditary pigmentation and some lines. You didn’t mention in your question whether or not there is a history of smoking, any issues of allergies and sinus problems which are things we need to know before making recommendations in our practice.

Technically there is a relative deficit of volume in the tear trough and the eyelid to cheek junction. Generally for this area, we use a filler like Juvederm, but I prefer to use Restylane as it is a bit softer. In my hands, Restylane works better and it can make an improvement. I often combine Restylane with platelet-rich plasma (PRP) which is derived from your own blood and contains growth factors and elements of the blood required for wound healing. What we do is successfully improve skin quality and get some long-term benefit from its combination with a hyaluronic acid filler.

That said, I would caution that you have to be prepared with these types of procedures to them continuously to maintain a certain look. For some young people especially in our area in New York City, we have a lot of actors, and people who are in front of cameras, so they will make the time and investment, but that it is a different scenario when a person who is 20 has this issue compared to someone who is 40. For a 40-year-old, it is an aging change of volume loss, but with someone younger, I just want you to be sure you are willing to do this long-term.

With that said, what is nice about these modalities is they are not permanent. You can try it and see if you like it, and decide if it is worthwhile for you. Again, I would be cautious about someone who is very young like yourself in this type of correction because the time and often the resources can be somewhat challenging. In addition, you have to understand whenever you have a procedure, even if it is done with minimal trauma, with blunt cannulas which is technique to minimize bruising, there is going to be some swelling. There is still potential for bruising so you have to factor this into your life.

From the perspective of skin care, you might have some options to first try skincare options of topical creams. In our practice, we have our own skincare line, and we help people customize what might be a good solution to improve skin quality, skin color, discolorations, and irregularities with topicals, but it takes a little time as opposed to something like a laser.

Learn more about your options and don’t just jump in and do something. There is still an option of not pursuing it beyond the initial experience because the material is temporary, whether it is Juvederm or Restylane or any injectable filler. If you don’t feel like doing this at this point in your life, you can wait till much later. I hope that was helpful, I wish you the best of luck and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 59 reviews

Juvederm For Under Eyes

Thank you for sharing your question and photo. The hollowing you are experiencing is a very common problem for people your age. Dermal fillers are an excellent way to restore lost volume to the tear trough area and will make you appear well rested. In my practice, I have had great results using Restylane, a hyaluronic acid filler that gives very natural and smooth results under the eyes. Although Juvederm is a great filler, it tends to attract water and can look less natural in this location. I recommend consulting with an experienced injector who will be able to provide you with specific recommendations in person. Best of luck with your treatment. 

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Can Juvederm fix my hollow under eyes? Or lower eyelid surgery?

Belotero® and Restylane® are considered the current FDA-approved gold standard fillers for treating undereye hollowness, which can indeed improve the appearance of under eye circles. As filling the under eyes is an advanced procedure, please consult a board certified aesthetic dermatologist for a consultation. 

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 8 reviews

You will benefit from Fat Fill

Hi. If you are looking at more permanent alternatives, you will greatly benefit from fat transfer to the undereye region and smile lines. They also improve the quality of the overlying skin. 

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

Fillers, lasers, microneedling/PRP do very well to treat this area. I am not a fan of Juvederm in the tear trough area. I suggest you see an expert. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Can Juvederm fix my hollow under eyes? Or lower eyelid surgery?

Can Juvederm fix my hollow under eyes? Or lower eyelid surgery? (photos) Baltimore MD
Yes, you can and should have some filler under your eyes with a board certified dermatologist or plastic surgeon. I recommend Bob Wise a board certified dermatologist in Baltimore. I would recommend Restylane as it looks more natural in this area and that is what I fill under my own eyes with. Good luck.

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Hollow Under Eyes

Thank you for your question. I typically use the hyaluronic acid injectable filler Restylane for volume loss under the eyes with a microcannula . I would recommend an in person exam to determine your candidacy.

Dr. Kathleen Morno

Kathleen Morno, MD
Highland Park Physician
5.0 out of 5 stars 1 review

Hollow Under Eyes

Juvederm is not a go to filler for this area. I normally use Restylane, which is also a hyaluronic acid filler to be placed in the under eye troughs. A filler will definitely give you some volume in this area, but will not do anything for the darkness...possibly even make it look more pronounced. We sell an eye cream called Teamine, made by Revisions Skincare, that has had some success for darkness under the eyes.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lower Eyelid Fillers for Hollow Under Eyes

Thank you for your question.  I agree that you appear to have hereditary hollow under eyes.  In my opinion the safest and most effective treatment for this is hyaluronic acid fillers like Restylane.  In some patients Voluma is also very effective in this area.  Juvederm is a close relative of these fillers, but it is not a good choice for under your eyes.  Juvederm is great elsewhere on the face.  However under the eyes Juvederm can tend to swell for a long time, which would give you less than an ideal result.

Hope this is helpful. 

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 23 reviews

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