Is Evolence Recommended for Filling Under Eye Hollows?

I heard that Evolence lasts longer, but it can cause lumps that can not be dissolved like HA fillers can. If this filler is not recommended, what would be a good filler to use to fill under eye hollows?

Doctor Answers 7

Evolence for under eye hollows

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Evolence has been pulled from production and is no longer available.  It was a fair option for filling tear troughs, but fat transfer is my first choice and hyaluronic acids like Restylane my second favorite filler for around the eyes.  Fat is the best because I can get much more volume and it is your own natural tissue, which most people prefer.  Results are really great and last several years.

Chattanooga Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

Under Eye Hollows and Non Surgical Eye Lift

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Dear Tina5

My wife, Dr. Lisa Airan and i wrote the first paper on the Non-Surgical Eye Lift in 2005. We describe the technique using Restylane and Perlane. We have treated thousands of patients with very few problems. We have been using Restylane in this area for over 7 years now and are very confident with the results- they last 8 months up to a year and a half. The results are very reproducaible and give a natural appearance. i have seen some cases where another product has been used and the product can not be removed..... and in this case if you have a long term problem you are stuck with it. Restylane and Perlane can be removed with an injected enzyme if need be.

These injections ( in the eye area) are off label - not FDA approved.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Wait for Evolence Breeze and then Maybe

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Evolence is a porcine derived collagen filler which, if done properly, can give a somewhat more natural appearance than the hyaluronic acid fillers. After all your skin derives its youthfulness from collagen. It is the breakdown of collagen which ages skin, so it seems logical that adding collagen to the dermis should assist patients in maintaining a more youthful look.

However, the under eye area is definitely not a good place for Evolence. It is meant for deeper, thicker areas of the face. Not the thin skinned, somewhat transparent sub-orbit. Perhaps, when Evolence Breeze comes out, this might be a possibility. This product is designed for the upper dermis, and more superficial portions of the skin.

Even then, it might not be the best choice. There is no "eraser" such as hyaluronidase for collagen. Plus, Evolence may last up to a year, so, unlike a boo-boo with Botox, you would be stuck with looking ( and having people look at) unsightly bumps for a much longer period of time.

There are better choices for this area. Restylane for instance. As Dr. Weimer notes real self is replete with patients complaining of bad results even when Restylane or Juvederm are placed in the under eye area. Imagine, what would happen if an inappropriate filler was injected

Hope this helps.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Not Evolence

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Evolence is notorious for lumping and must be quickly massaged. The thin skin in the eye area would increase the chances for lumps. My favorite in this area is Restylane.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Evolence Not Recommended; Use Juvederm or Restylane

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Hi Tina5,

Evolence and Juvederm are both indicated by the FDA to last the same amount of time - up to 12 months. Evolence is a moderately thick product and wouldn't be the first choice for the average person to use in the thin skin area under the eyes.

Restylane and Juvederm work well in these areas. I would strongly recommend these products over Evolence.

Lawrence Osman, MD
Los Angeles Dermatologic Surgeon

You could use Evolence, but Restylane is a better choice

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Evolence is a great filler but it can't be dissolved with hyaluronidase. It also sets up very quickly and can be nodular if not massaged right away. Restylane has been used in the eye area for a while with a very good safety record. This is my choice. Going through Realself, you will see that a majority of the problems with fillers is in this area (tear troughs, eyes). That is why you need to pick your physician carefully. The tendency is to fill with too much filler.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

You a hyaluronic acid instead

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The hyaluronic acids are the safest for the reason you mention. They can be dissolved if it is too lumpy or if there is a complication, the filler might be digested helping prevent a further problem.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.