Which Filler is Best for Under Eyes (Tear Through) Fat Grafting or Artefill Injection?

I have hollowness under my eyes after my quad blepharoplasty. The surgeon recommended FAT TRANSFER under my eyes, tear through, and cheeks to fill the hollowness. It will cost me $4,000. I asked for a second opinion from another Doctor and she recommended ARTEFILL INJECTION to fill the hollowness under my eyes, tear through and cheeks,for $800 per syringe.The Doctor told me she will start me with 2 syringes $800.00 per syringe. Please advise me which procedure is safer and better effect.

Doctor Answers 7

Reversible procedure is best!

I would recommend getting another consultation with a surgeon in your area that is comfortable with the hyaluronic acid (HA) fillers, Restylane or Juvederm, in the lower eyelids. With any procedure, the surgeon and the patient need to understand the "risk-benefit" ratio. The risk of having problems with fat transfer or Artefill is much greater than HA fillers. The results of the HA fillers are very good, can be reversed, last for several years, and can easily be supplimented in the future. All good things.

Good luck!

Eugene Oculoplastic Surgeon
5.0 out of 5 stars 1 review

Fat Transfer

Juvederm and Restylane are commonly used, but this has risks of causing some puffiness if too much product is used. Thank you for your question and good luck with everything.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Hollow eyes

My best results, by far, in this situation are with fat grafting.  I can get right to the area that is the problem and it is long lasting.  That is not to say that another doctor couldn't get good results by another method.  Some people would use filler and some might reposition fat (another eyelid surgery).  Find someone you trust, who examines you closely and go with their recommendation.  After all, that is what you are paying them for--their experience and expertise.  Good luck!

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.7 out of 5 stars 45 reviews

Filler for Tear Trough of Lower Eyelid

I would not use a permanent filler like Artifill in the tear trough of the lower eyelids. I prefer the hyaluronic  acid products. Restylane seems to cause less temporary swelling. I have also used fat in this location for over 20 years.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Fat transfer is a good option for under eye hollow

Plastic surgeons have long practiced the adage "replace like with like" meaning for example if fat is what is missing, replace it with fat. I would hesitate to use a permanent filler such as Artefill in the under eye area, but I routinely use fat transfer and believe that it looks natural and lasts well. You could always try one of the HA fillers such as Juvederm or Restylane to see what the addition of volume can accomplish and then go to fat when they have gone away.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Under eye hollows treated with fillers vs fat transfer

It is very common to experience hollows under the eyes, especially after lower eyelid surgery. Volume replacement is a very simple and effective treatment. I do use both synthetic fillers as well as fat depending on the patient. I believe that reversible fillers offer a level of safety and comfort for the patient. Generally I would recommend a hyaluronic product such as juvederm or restylane. Fat can be transferred into this area very successfully but takes a bit more work for harvest and transplantation. I reserve fat transfer for those patients that need a total facial restoration as opposed to only needing volume under the eyes.

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 53 reviews

Fillers for under eye hollowness.

I would not use fat since this can easily form scar around the fat and look like a lump. Artefill is permanent and if a little to much is placed it can make a bump. I use Juviderm since it is about $600 a syringe and you should only need that amount or less. It is reversible. The only downside is it lasts 1 year,  but most patients need so little and the rest can be used elsewhere on the face.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.