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

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!

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!

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

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.

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.

Thank you for your question!  The issue is with injection technique and not the filler itself. Restylane is in my opinion the ideal filler for the undereyes. However, if the filler is placed too superficially, or if the too much product is used, then undereye swelling and Tyndall (bluish grey discoloration) can be seen. I recommend seeing another injector for a second opinion. Best of luck! 

Typically, the area under the eyes is more sensitive than other areas and less forgiving with fillers.  In general, Restylane is still a good choice for under the eyes, especially in Asians.  The results are more dependent on the actual injection itself more than the product used.  Please consult with an expert injector, who can assist you with achieving the results you seek.

I think the issue is with injection technique and not the filler itself. Restylane is in my opinion the ideal filler for the undereyes. However, if the filler is placed too superficially, or if the too much product is used, then undereye swelling and Tyndall (bluish grey discoloration) can be seen. I recommend seeing another injector for a second opinion. 

Although it might sound as an safe option, most sub optimal results from under eyelid fillers comes from the choice of using a blunt tip cannula. From your story it seems likely that the gel is not positioned well rather than not the suitable filler for a certain race. The best option in most cases is to have it dissolved more before switching to a very experienced injector.

Fat grafting is a wonderful option to fill the tear trough and treat the lower cheek/eyelid junction.  It is more permanent than any filler.