Herniated Fat Pads Under Eyes. Would Belotero Be Effective? (photo)

I have read about a new alternative to Restylane and other fillers, called Belotero. I have a serious case of herniated fat pads under eyes, and am curious whether injecting Belotero might disguise these. I also read that this is FDA approved. Is that correct? Thank you.

Doctor Answers 17

Beletero for herniated fat pads?

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Nothing short of blepharoplasty can fully correct a weakened or defective orbital septum with herniation of fat.  But I have seen tremendous improvement in this problem with Beletero.  Beletero dies nit pull ir push the fat back, but it can smooth the furrows and hollow areas such that the fat is less apparent.  

You should undergo a careful pretreatment evaluation, including a history and examination, before having Beletero. and physicians will be cautious about injecting anyone with a history of puffiness under the eyes in the morning that improves during the day. Your dictir will also be cautious about injecting someone who has had surgery to the lower eyelids, as these patients can have compromised lymphatic drainage from their lower eyelids, making it difficult to for the periorbital muscle and lymphatics to eliminate the fluid that is attracted to some types of fillers. It might help also to limit the amount of filler injected in this area in one session.            

You can try the Beletero first to see if you are happy with the degree of correction, especially since it is very difficult to inject fillers under the eyes of someone who has already had lower eyelid surgery without getting some side effects, such as persistent edema. 

New York Dermatologist
4.7 out of 5 stars 10 reviews

Belotero is a great choice for under eyes

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Belotero is a new FDA-approved filler with properties that make it ideal for treating under the eyes.  It is important to know that this is an off-label indication for the product.  It is approved for naso-labial folds.  This is a difficult injection, so make absolutely sure that you are going to a board-certified facial plastic surgeon, general plastic surgeon or dermatologist for treatment.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

Belotero - New FDA Approved Filler for Under Eyes and Other Areas

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Belotero would be a good option for injection under your eyes to help disguise your herniated fat pads and improve the appearance of this area. It is a soft, flowing filler that is usually injected superficially and can be molded to give the best results. Belotero is FDA approved for the same indication as other hyaluronic acid fillers such as Restylane and Juvederm. 

Hema Sundaram, MD
Fairfax Dermatologic Surgeon

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Boletero eyes

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Yes Boletero can easily and safely be injected in the under eye area even if you have fat pads. We do not inject the fat pads, as the only solution for this a surgical option but we can reduce the  deep furrows under the fat pad to hide the fat pad protrusion. This will take away some of the "tired look". It must however be injected by a skilled injector because overcorrection in this particular situation will look awful!

Cynthia Stolovitz, MD
Montreal Physician

Under eye bags

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Fillers such as Belotero (and now, Volbella) can fill in tear trough deformities under the eyes.  They are both FDA approved agents for injection.  Fat pad descent, however, is best treated with a blepharoplasty that actually removes these bags.  Injectable like Belotero may lessen their appearance, however, by smoothing the transition.

Regina M. Fearmonti, MD
San Antonio Plastic Surgeon
5.0 out of 5 stars 22 reviews

Belotero for herniated fat pads

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With regards to "herniated fat pads", one would need a lower blepharoplasty with fat pad transposition to help correct the tear trough deformity.  Dermal fillers, such as Restylane and Belotero, may help correct these tear trough deformities as a temporary solution.  I would recommend a bigger molecule such as Restylane for tear trough deformity correction.  Any excess skin and lower lid laxity will not be corrected by injection with a dermal filler.  Make sure that you're evaluated by a plastic surgeon before your procedure.

Boletero works well in the right hands for lower lid depressions

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Boletero, Juevederm, and restylane (HA fillers) do not replace a blepharoplasty which can re-position or lessen the bulging fat. Instead it makes a smooth transition between the lower lid fat pad and cheek pad. In mild cases it can improve your appearance allowing you to delay the blepharoplasty procedure, or it can be used in conjunction with the lower lid lift in a synergistic fashion.

Belotero for under eyes

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Belotero is a newer hyaluronic acid; however, it's one of my favorites as it is currently the thinnest filler on the market (Restylane Silk, which will make its debut in 2015, maybe even thinner). It works great in thin areas such as around the eyes to camouflage fat pads and in lip lines. Around the eyes, we're getting more than a year in many patients. Around the lips, unfortunately, similar to the other hyaluronic acids, we are getting maybe 4 months.

Around the eyes, you really need an experienced injector.  It will not camouflage the bags completely however it can make a nice improvement in the area.  Belotero is not FDA approved around the eyes (but neither is any other filler and Belotero is still used in this area).

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Herniated fat pads under eyes

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Belotero is a great filler for under the eyes.  It is a hyaluronic acid filler that is less viscous than other fillers.  This makes it a great choice for under the eyes as it can appear less bumpy/lumpy. 

That being said, you need to be careful when getting filler under the eyes if you already have some bulging or puffiness there- sometimes fillers can worsen the appearance of this puffiness. 

I would recommend that you find an expert injector in your area who is experienced with under eye fillers.

Erica Linnell, MD
Bellevue Dermatologist

Belotero for tear troughs

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Belotero would an excellent choice in your case. This product is not FDA approved for this particular indication. Careful placement of product in this area can ease the transition between the lower eyelid and the mid cheek area. 

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.