Volbella versus Restylane for tear troughs...which is a better choice?

These are classic controversies or questions raised by both patients and professionals. I find that while there differences in the products, it is ultimately the injector that counts the most! You may need to seek another injector, one with years of experience and one who has a light touch and an artistic eye. That combination is not easy to find. But once you find that person, stick with them. Getting to know your face takes time and repetitions. Good luck as you pursue your goal. 

Hello,As mentioned by one panel member, the technique of the injector will outweigh the choice of Vobella over Restylane.  However,  most tear trough injectors tend to believe that Restylane is better at a more predictable outcome.  Having a "lighter" or thinner gel does not matter if being done by an experienced injector.  Given your anatomy, it would appear that the placement is not ideal for you.  We prefer not to use a cannula as this sometimes creates more challenges with placement and artistry especially in the tear trough location.  Finally, there are early reports that continue to grow of concern with Voluma and Vobella not easily being dissolved with hyaluronidase when there is a lump or bump.  With Restylane, this is not an issue.  Also, from a cost perspective, Restylane generally is less of an expense.

Every doctor has their own preference. 
There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Volubella like Belotero are runny products.  The marketers like to call them "smooth." The manufactures like runny,.. err smooth pproducts because most injectors are just no good at the service and make lumps and bumps with the high G prime filler Restylane. G prime is a measure of the rheology of the hyaluronic acid filler.  The higher it is, the more like a solid it behaves in the tissue.  That is actually highly desirable for filling an under eye circle.  We want to be able to place the product, carefully sculpt it in place and have it stay they.  Low G prime fillers are more like liquids in the tissue.  Once they are placed, they drift.  That is a very bad quality in the lips and in the under eye tear trough area. If you want a disappointing result, go to someone who does not see much difference between Restylane and Volbella. These are fussy services so yes, finding the right injector is challenging.  It is the reasons that I have patients who fly in to seem me from all over the world for this service.

Thank you for your question! There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals. Best of luck!

Restylane is the filler that is most recommended by injectors for the tear trough area.  I believe Volbella could also be a good choice, but like others I believe it has less to do with the product and more to do with choosing the best candidate for under eye filler and placement technique.  
I have seen in our practice that the best filler outcomes for the under eye long term come from placing the filler deeper (on the periosteum) instead of more superficial (closer to the skin).  Best of luck to you!

You can get lumpy results with both Volbella or Restylane. You can also get excellent smooth results with both. The most important factor is to make sure your injector is familiar with your anatomy and understands how to adjust their injection technique for the filler type to avoid the lump appearance. I also find that the location and amount of injection needs to be modified in my asian patients to adjust for the difference in skin and orbital anatomy. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon

I almost always use Restylane for tear trough injections.  I have also had success with Belotero.  You should be aware that the most important factor in ensuring smooth results is the skill of your injector, not the particular brand of filler used.  A great injector can get great results with many different fillers.  Regards,Dr. Ort

I believe your injector had placed too much filler material under your eyes during your procedure. Eye trough filler technique is always “less is more”. Meaning during the procedure, we want to fill it just enough to see improvements and NOT fill it until we see complete fill and flatness to the troughs because during healing Restylane and Volbella will still pull water towards the filled sites. It always good to be under filled to compensate water swelling afterwards. If your injector placed fillers to completely flatten your troughs during the procedure, then they may have placed too much and you may end up seeing lumps or humps during healing and afterwards. Injector experiences is critical as well as their artistic vision. I prefer using Restylane-L over Volbella. Even though Volbella is thin but Ive heard from others that Juvéderm products does pull more water than Restylane.