Is Restylane a Good Option for Under Eye Bags? (photo)

I am 40, living in London and look constantly tired due to the bags under my eyes. I have read rave reviews on restylane injections on here but when i asked a cosmetic surgeon in London he was luke warm at the idea of doing the proceedure, and recommended fraxel laser instead. Is restylane the way forward and can anyone recommend me a specialist in London as I've read that you must use someone with a wealth of experience. The cost of the proceedure is unimportant.

Doctor Answers 10

Restylane and lower lids/tear troughs

Based on the photo you've posted, you look like you'd be a great candidate for a dermal filler, done by a well-trained provider. I would visit with another provider and weigh options - done correctly, you'd likely have a nice improvement of this area.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Is Restylane a Good Option for Under Eye Bags?

I certainly agree that you should have only a board certified plastic surgeon with a wealth of experience perform any procedures on you.  Fraxel laser resurfacing is certainly a viable option for fine lines and wrinkles, but will not eliminate the “bags”, which are most likely fat deposits in the 3 chambers beneath your eyelids.  This is best handled by what is called a blepharoplasty, which is when an incision is made just beneath the lower eyelid and the fat deposits are removed and generally a small portion of skin removed also.  Many surgeons will also insert a suture to anchor/pull up the  skin and underlying tissues so the skin in this area is no longer sagging. 

Jonathan Ross Berman, M.D. , F.A.C.S.

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Filler for under eye bags

I think a filler like restylane or juvederm would be reasonable to try in your case as you certainly have a tear-trough deformity. You would definitely have some nice improvement, but the question would be whether the benefit would be sufficient for you, or whether you might consider in addition a blepharoplasty. If you're surgically-averse, definitely worth trying the filler in well-trained hands such as a dermatologist or plastic surgeon.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Lower Blepharoplasty

Hi Mailwriter in London,


It appears from your photo that you might need a lower blepharoplasty to address the fat pads and the excess skin.  I believe that  Restylane alone would not address your situtation.  After the lower blepharoplasty, Resylane can be injected to minimize the tear trough.  It would be a pleasure to take care of you.  Good Luck!

Dr. David Alessi

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Lower lid issues

Restylane is great when used correctly to treat the depressed tear trough region, but you may be a candidate for a lower lid blepharoplasty treating hernated fat pads and trimming some loose skin. The restylane can be used to supplement in the tear trough once things have healed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Fraxel will tighten, but that isn't the issue here - you are right!

I agree with you that you would do well with Restylane.  While Fraxel could tighten, the issue we have here is volume, not laxity per se.  If you fill the area UNDER the eyes, you should have a nice improvement, but keep in mind that you have to avoid the area immediately below the lid and would focus mainly on the upper cheek near the eye to build that area up. 

Fraxel could do a decent job on the area below the lids, but that alone won't get you where you want to be.  Fillers and volume replenishment are the answer here.  Good luck!

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 reviews

See BC Plastic Surgeon Or Ophthalmic PS For Eyelids

You should obtain a consultation with a BC plastic surgeon or ophthalmis plastic surgeon to discuss your options.  Restylane will treat only your tear trough and is temporary.  It looks as if you are candidate for a lower lid blepharoplasty with attention to the tear trough as well.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Filler for dark circles

Filler (Restylane) under your eyes to fill in the dark hollow circle is a very good nonsurgical option for you. I am sure they are people in London who do it (seek an oculoplastic surgeon).

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

I do a lot of under eye Restylane and you should do great with it.


The great thing is you can get help with this without surgery.  The bad thing is that with thin skin (which you have) the treatment is fussy.  It is common to need an adjustment.  So it is ideal if you can find a fussy injector who is close to where you live.  If you can't find this type of individual, you are welcome to come to Los Angeles for treatment.  Plan to spend about 4 days in the area so you can have treatment and be seen before leaving to return to London.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restylane for lower lid bags

I perform Restylane to the lower lids a lot and I do not think it will work well for you. I think that you would probably do best with transconjunctival blepharoplasty. This is the removal of fat beneath the muscle thru the inside of the eyelid (no visible scars).  I do not think Fraxel will work well but it's your money. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

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