Which filler is better for under eye tear troughs for Asians? I’be tried Restylane twice and both times it’s lumpy.

Question

I had 1 syringe of Restylane split between both under eyes using the blunt tip cannula. At 5 weeks post injection I could still palpate the Restylane ridges under my eyes. In fact the left eye has a purple shadow like a bruises and is raised. I saw the surgeon who injected a tiny amount of the enzyme to dissolve it, but there’s still a visible lump. Is Restylane even the right filler product for Asian tear troughs? What is the best filler for under eyes? Should I try Restylane again?

Nima Shemirani, MD · Answer

Hi @Meikameo. You can try Belotero if Restylane does not work for you.  I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck to you, Dr. Nima!

Steven H. Williams, MD · Answer

Hi,Thank you for sharing your question.The tear trough is a very unforgiving area, especially with dermal fillers. Lumpiness is a possibility after fillers depending on the product used, injection technique, and patient skin quality. Typically restylane is a good product choice for tear troughs if placed correctly. Often types, injection technique is more important than the product selection.Make sure to see an experienced, board-certified provider.Hope this helps!

Jason Emer, MD · Answer

These fillers (Belotero, Volbella, Restylane Silk) are good for improving under the eyes, but keep in mind, a combination approach will give the most improvement. Fillers combined with lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

Yes, Restylane is a fussy filler to use. It has one of the highest G primes of any of the hyaluronic acid fillers (second only to Lyft). By comparison, the Allergan Juvederms and Voluma are much more runny (or according to their marketing material-smooth). Runny products are much less likely to make lumps but they also do not hold in the under eye area. You don't need a different filler, you need a different injector. Restylane is the right product.

David W. Kim, MD · Answer

Hi Meikameo,Restylane is a commonly used filler for both Asian and non-Asian tear troughs. In fact, in our office, it is the filler we use the most for tear troughs. However, there are a couple of other good filler options as well, so it would be reasonable to try a different filler next time, if your injector feels that would be appropriate. Depending on your injector, you could also try a different injecting technique. It's hard to make a specific recommendation without seeing you in person. Hope this helped a bit.

Which filler is better for under eye tear troughs for Asians? I’be tried Restylane twice and both times it’s lumpy.

Answers (5)