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I have seen disastrous results from sculptra injections under the eyes. I also know of physicians who like to use sculptra in this area and claim to do so with excellent results. The area under the eyes is highly unforgiving and, once placed, sculptra cannot be easily modified or removed. I would use hyaluronic acid fillers in this areas.
Since the under eye area is more susceptible to potential problems than any other area, the general response would almost always be a firm No. That’s not to mean that it’s not done or can’t be done, but it’s an extremely technique-dependent procedure and there are additional factors to take into account that should influence recommendations. Some of these factors include • Thickness of skin • Age • Patient historical response to injectables • Medical conditions and health levels • Patient lifestyle • Injector experience level Because undereye skin is quit thin in almost everyone compared to other facial locations, the potential for bumps and nodules is much higher. And because that skin is thin, any lump or bump, no matter how small, will likely be visible. Patients who have more profound swelling to injectables in general will have a higher potential for problematic outcomes. Lifestyle which includes heavy exercise, a lot of outdoor time that makes frequent squinting more likely, medication or alcohol use which can mean spikes in dehydration, and heavy intake of sodium, all have potential to disrupt expected outcome with injections in sensitive areas around the eyes. Obviously, even the most skilled of practitioners can experience an unexpected response, and with any injectable, there is always some risk of an adverse outcome – though mostly this is transient bruising or swelling. Most patients looking for under eye correction are better served choosing a hyaluronic filler such as Restylane because it can be reversed, Restylane is a biodegradable gel and not a collagen stimulator and the problems associated with hyaluronic gels in this area are very very low. Undereye hollows can also be seen when there is less bony support or soft tissue in the midface. In these cases, Sculptra can be used very successfully to correct midface volume, which then has the effect of lessening "undereye" hollows without specific treatment to the eye area. Unless your injector is at trainer level with Sculptra, I’d recommend a hyaluronic gel alternative in the eye area. There’s no reason to take a chance when something much less controversial will accomplish the same end result.
Almost all reputable and experienced Sculptra physician injectors will advise avoiding Sculptra injection along the hollows of the lower eyelid or tear trough areas. The risk of nodules is substantial in this area. The key is to avoid injecting above the orbital rim that one can palpate. Immediately during the post-Sculptra injection massage however, an experienced Sculptra physician injector may gently massage the freshly injected material from upper cheek to lower eyelid areas.
Sculptra is a fantastic product and my patients who have benefited absolutely love it and look great...i have injected it into the temporal hollow, the malar/cheek area (below the lower lid/cheek junciton), the lateral cheek/mandibular angle and the chin....all areas of soft tissue and bony loss as aging progresses. There is a secondary benefit in the lower lids, but I would be VERY cautious with a direct injection into the lower lid area. I think hyaluronic acid (juvederm/restylane/etc.) are great in this area, but should only be performed by very experienced MD injectors. Good luck! Dr. C johnconnorsmd.com
Sculptra can be used for the tear trough if placed underneath the muscle but I would not use it for the lower eyelid hollowness between the bony orbital rim and eyelash margin because lumpiness is a high possibility here and serious complications too. The hyaluronic acids are safer such as restylane.
