Is Restylane a good option? (Photo)

I've always had deep tear troughs but within the last year I noticed I can no longer fully cover them with makeup, I have to apply more than I like, and I don't look fresh at all when not wearing any. I just look tired even though I work out daily and get enough sleep. The volume has fallen and the eyes combined with marionette lines are making me feel older than my age. Mostly I am concerned with the eyes though for now. I'm hesitant to do something permanent, but would like more feedback.

Doctor Answers 18

Fillers are a good option for tear troughs, even better when combined with PRP. Fillers can also help with marionette lines

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Thank you for your question. You state your tear troughs were always deep, but lately you’re finding it more difficult to cover them with makeup. You say this, in combination with your marionette lines, makes you look older than you actually are.

Facial rejuvenation makes up a big part of my daily practice, so I can give you some guidance on this matter. I’m a Board-certified cosmetic surgeon, certified by the American Board of Cosmetic Surgery, and a Fellowship-trained oculofacial plastic surgeon, through the American Society of Ophthalmic Plastic and Reconstructive Surgery. I’ve practiced in Manhattan and Long Island for over 20 years.

When I treat cases like yours, it’s important to step back and take a look at the big picture, rather than just focusing on the problem area, so I look at the eyelid-cheek junction, the cheek’s structure, and the balance of the whole face. The challenge with facial aging is that you’re not just dealing with soft tissue loss around the eyelid area, but also loss of bone, muscle, and fat. This is the reason for the appearance of pronounced nasolabial folds and marionette lines.

One of the most common errors in the fields of cosmetic surgery to cosmetic dermatology is the chasing of lines. With the advent of cosmetic fillers such as Restylane, we are able to address lines quite aggressively. However, I have found that when patients come to me expressing dissatisfaction in a filler treatment that they had done elsewhere, more often than not, it is not because of technical reasons regarding the way it was done, but rather because they feel they don’t look well-rested enough.

We can treat the tear trough area with Restylane, but I think there would be some added benefit in combining it with platelet-rich plasma (PRP) to also improve overall skin quality. Platelet-rich plasma is derived from your own blood that contains the healing growth factors that stimulates skin quality and improves complexion. On the other hand, people looking for this type of solution often also happen to have puffy under eye bags. If the under eye bags are too prominent, then it’s not worth it to do Restylane alone.

I would say that it might also be worthwhile for you to learn about a procedure called the Y Lift™. The Y Lift™ is an elegant procedure that involves adding volume into the deeper structural levels of the skin, unlike the traditional way of adding volume into the soft tissue of the face. Often when we combine the tear trough treatment with cheek augmentation or cheek lift, then the whole eye area looks so much better because it’s more balanced. The Y Lift™ can also improve the jawline, chin areas, and marionette lines.

I think what’s important to keep in mind when you’re learning more about your treatment options is the whole is greater than the sum of the parts. Ultimately, Restylane is an option you can look into, but I would also suggest looking into improving skin quality, texture, and complexion, to give you even more of a youthful look overall. Try to do a bit more research and meet with qualified, experienced doctors who perform these procedures.
I hope that was helpful and I wish you the best of luck!

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New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Restylane for tear trough

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Restylane injections can help fill the volume in the tear trough area.  It's important to seek an experienced injector for this sensitive area.

Anatoli Freiman, MD
Toronto Dermatologist

Injections with Restylane

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Restylane is a great option for volume loss in the tear trough. I would recommend to seek an experienced injector who does a high volume of injections and uses the blunt micro cannula. Our practice falls in the top 2% in the nation for volume and we have been awarded Black Diamond Status through Allergan.

Dr. Daniel Ritacca

Daniel J. Ritacca, MD
Chicago Oculoplastic Surgeon
4.4 out of 5 stars 20 reviews

Restylane tear troughs

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Thank you for your question.  Yes you are a good candidate for Restylane injected into your tear troughs.  I recommend a blunt micro cannula technique.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Resylane is a very good option for mild lower eyelid bags

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Thank you for sharing your question and posting your photo. Resylane is s great option for the treatment of mild bags. In your case, the skin looks a little dark as well as puffy. The "bags" can be masked by Resylane injected into the tear troughs. The darkness might be due to thin skin revealing your blood vessels beneath it. If this is the case, only coverup works well. See an experienced eyelid surgeon for comprehensive evaluation and discussion of possible treatment options. Good luck.

Restylane in the Tear Troughs

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We have utilized Restylane in our office to address patients' deep tear troughs. We have found that Perlane is typically to dense for the fine skin around the eyes.

I suggest you consult a board certified facial plastic surgeon to receive the highest quality knowledge, treatment, care and skill available. A consultation provides you the opportunity to relay your concerns and desired outcome to the surgeon while the surgeon can assess your health profile and discuss his/her pertinent advice.

I am also attaching a video that provides steps to follow to assist you in avoiding skin problems down the road.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Restylane to the tear trough and lower eyelid region

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Thanks for your question about tear trough correction.

In my practice I have found good success with injections of restylane around the tear trough to minimize the appearance of bags under the eyelids and create a smoother and more rested appearance.  Visit with a skilled injector in your area who has experience with treating in this area.  I recommend a board certified plastic surgeon, or board certified dermatologist with known skill in treating around the eyelids.

Best Wishes

Steven M. Camp, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 120 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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I suggest fillers and lasers to improve this area in combination.  Please see an expert who does a lot of treatments in this area.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Restylane for tear troughs

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From your photos, I think you would be a good candidate for filler in the tear trough.  Restylane is the performed filler choice for most providers.  Good luck!

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon


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Thank you for your question and photo. Yes, Restylane would be a good option for the tear trough area. It is an ideal filler for the tear trough area for many reasons. It creates a natural rejuvenation in the area, it's long-lasting, and finally it's a hyaluronic acid filler, so it can be reversed. Be sure to visit a board certified plastic surgeon or a certified nurse injector specialist.

Best Wishes,
Dr. Newall

German Newall, MD
Houston Plastic Surgeon
4.4 out of 5 stars 57 reviews

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