I have wrinkles around the eyes and would like to try some filler. Is Juvederm the best one?
Best Filler for Eye Wrinkles
Doctor Answers 19
Juvederm , Elevess and Cosmoderm are all very good for superficial or medium creases.
If you have superficial or medium depth creases then Juvederm, Elevess or Cosmoderm are good choices. If the lines are dynamic creases which means that they show up mainly only when you smile then Botox is a good choice. There are no allergies to any of these materials and can be injected at your initial consultation very easily. Juvederm and Elevess are similar to Restylane but last alittle longer. (approx 6-9 months) Cosmoderm lasts approx 3-4 months which lasts about the same as Botox. Bruising and alittle swelling or redness is normal and goes away in a day or two. Some patients need both a filler and botox together which can be done on the same day.
Fillers may not be the answer
Wrinkles around the eye can be a difficult problem. Place your finger on the bone around your eye. If the wrinkles are on the skin between the bone and your eye, fillers should not be used in that area. For wrinkles along the outside of the eye (near the temple - often called the crows feet area), often Botox is the best solution. For other wrinkles or depressions around the eye, several products have been used off label. I would agree that the injector is more important than the injectible. The area around the eye is a difficult area to get a good result and requires a different injection technique than other areas.
Hope this helps.
Best Treatment for Wrinkles Around the Eyes
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The injector is most important for filler around the eye, but don't use Juvederm
When you get filler around the eyes, you mainly help the sunken areas around the eye and tear trough area. The fine lines are only slighly corrected. Restylane seems to stay in place better than Juvederm and Juvederm can lead to prolonged edema around the eye. More important than the filler is the injector and placement. This is probably the most difficult area to inject well. The injection needs to be deep to the muscle and sometimes, just superficial to the bone. If the filler is placed too superficial, bumps and blue tint to the skin (Tindel effect) are seen. These injections are more prone to bruising than other areas. Also, conservative amounts is better than overfilling the area. Surprisingly, the injections are relatively painless. Most people will get about a year duration with Restylane.
Steve Weiner, MD
Facial Plastic Surgeon
UPDATE: I ONLY USE BLUNT CANNULAS AROUND THE EYES NOT. LESS BRUISING, LESS PAIN, LESS SWELLING, AND SAFER.
Lines around the eyes
Filler may or may not be the best answer to your concern, wrinkles are usually caused by muscle movement of the face, in which case a neuromodulator would be the best line of treatment. The area to the side of the eyes (lateral, also known as Crow's feet) is best treated by a neuromodulator (Dysport) to address either static lines (wrinkles at rest) or dynamic lines (wrinkles that only present with expression). Lines presenting below the eyes, can be treated with dermal filler (hyaluronic acid) as high as the orbital bone that surrounds the eye can be palpated. This treatment is usually referred to as "tear trough filler" and when done by an experienced practitioner, can yield some amazing and natural results. The two treatments can also be done together. If the skin in the area is still lax, eye creams can help, or a more dramatic result can be achieved with a surgical blepharoplasty. Good luck!
Addressing eye wrinkles
Depending on your eye wrinkles, I would recommend the following:
1) for crow's feet - if only present when you smile or squint, start with a neurotoxin (botox/dysport)
2) for crow's feet that are also present at rest, start with a neurotoxin and also consider a filler (I prefer restylane silk, but belotero or volbella are also options). Can also add on microchanneling or an energy-based procedure such as ultherapy or radiofrequency.
3) for under-eye wrinkles, consider neurotoxin.
4) If you have crepey skin under the eye, use a good eye cream with retinol
This depends on which eye wrinkles bother you. The small lines that appear when you smile in the corner of the eye area are best treated with botox. Sometimes a little can also help with very mild creases directly under the eye.
Otherwise the deeper troughs / eye circles can be effectively treated with dermal filler.
So there are many good products available for improvement of the tear trough or eye bag area this is based mostly on clinician preference and technique (syringe injection or microcannular)
Personally, I use a different product mostly dependant on the type of tear trough the patient has - whether puffy / hollow / poor mid-face volume . For example improving structure and volume around the tear trough is an important first step. I usually use Juvederm volift / voluma to improve cheek and mid-face volume which can drastically improve the tear trough area in the first instance. Due to the thin and delicate skin in the actual tear trough, vobella or a similar softer filler (some also use Teosyal redensity 2) should then be used.
Make sure you choose a clinician with expert experience in injecting the tear trough area / advanced practitioner.
Hope this helps and good luck!
around the eyes such a crows feet, I prefer neuromodulators. If you could post some pics of what your wrinkles look like it would be helpful.
Most Effective Treatments for Eye Wrinkles
Fillers are generally used for the lower part of the face. Botox would be your ideal injectable for line and wrinkles around the eye. With that said, filler for mid-face volume loss such as Voluma can great enhance the area of your indirectly. Putting volume in the lateral cheeks gently pulls the cheek skin towards the ear. This often results in a subtle reshaping/softening of the under-eye area.
To fill or not to fill
Fillers are not always the answer. It matters exactly what the pathology is. So if these are fine wrinkles of the lower eyelid then a resurfacing technique such as a chemical peel or a fractional laser is best. If they are wrinkles laterally around the sides of the eyes then these are typically from overactive orbicularis muscle and Botox or Xeomen toxin can be used to paralyze the muscle which will decrease the appearance of wrinkles.
Fillers are better for "filling" hallowness, shadows and divots. They do have a roll in larger defined wrinkles but they are really most beneficial to augment adjacent areas that enhance and decrease the wrinkle in that way.
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.