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

Belotero is a new FDA-approved filler.  It is a hyaluronic acid (as are Restylane and Juvederm).  The approved indication for Belotero is for injection into the mid-to-deep dermis for correction of moderate-to-severe facial wrinkles and folds.  It normally can be used to improve the under eye area if there is a depression there.  

Typically reducing the appearance of herniated fat pads requires a lower blepharoplasty. It's not typically recommended to add filler to the area because it can make the area look puffier.

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, 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 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).

Belotero is a great choice for under eye treatment of a nasally located depression or shadow.  This is the area below the fat pad.  By elevating the depression, you make the fat pad less noticible.  This is FDA approved.  An advantage of Belotero is that you don't need to significantly undercorrect like some of the other fillers.  This is because it causes less of an osmotic gradient and draws less fluid to the region.  Good luck.  You look like a good candidate.