Best Filler for Under Eye Hollows and Fine Lines?

I would like reduce fine lines and fill in the hollow appearance under my eyes.

Doctor Answers 4

Restylane works best without delayed swelling like Juvederm

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Hi abdc,

Restylane in the under eyes appears to last around 12-18 months before patients return for a touch up. I will take follow up standardized photos when they come back for a follow up and the continued improvement even at the 12-18 month follow up means that there is still Restylane left over. The first time they patient has the treatment is also when they use the most amount of filler. After the "gas tank" is filled up, they usually don't come back unless it is 1/4 or 1/2 depleted, and they will use less filler than they did the first time.

Filling the under eye hollows or grooves along the rim of the lower eye socket is the goal of the filler injections.  The improvement of the fine lines under the eyes depends on the severity and location of the fine lines.  In many cases, the fine lines are due to the thin crepey skin of the lower eyelid.  As the hollows become filled, the skin is very slightly stretched over this additional volume and becomes less crepey and harder to pinch up the skin.  Some fine lines are due to overactive muscles from squinting or smiling, in which case using Botox, Dysport or Xeomin is the better way to treat those fine lines as opposed to fillers.

One unusual situation that I have encounter sometimes can make the fine lines worse after lower eyelid filling.  These are the exceptions to the typical patient.  These patients usually have a lot of sun damage, may be smokers, and appear to have skin excess in addition to very deep tear trough grooves or hollows.  I suspect that the hollows have been there so long and with their lack of skin elasticity, their skin has been stretched along the tear trough groove irreversibly.  If these patients are filled, the groove can be smoothed, but since the skin is irreversibly stretched only along the tear trough groove, this can cause the skin to bunch along the where the hollow used to be.  If skin is bunching, it can appear to be darker skin, not dissimilar to your elbow skin or knuckles on some people.  

For the remainder of patients, Restylane is a simple, long lasting enough, solution for lower eyelid hollowing, and small eyebags (not big ones.)


Dr. Yang

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New York Facial Plastic Surgeon
4.8 out of 5 stars 35 reviews

Fillers are very useful in softening under eye hollows

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Fillers are very useful in softening under eye hollows. Restylane and Juvederm are the best fillers for this area, in my opinion, because they can be dissolved if there is any problem with over correction.

William P. Coleman III, MD
Metairie Dermatologic Surgeon

Injectable fillers are wonderful for lower eyelid rejuvenation.

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Dear Adbc,

Fine lines and crepe skin of the lower eyelid are challenging problems. Lower eyelid grooves (hollows) respond incredibly well to injectable fillers. My preference is Silikon-1000 for permanent results, but the hyaluronic acis products like Juvedrem and Restylane work well in the right hands.

Let me know if I could be of further assistance, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

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Filler choice

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The hollows under your eyes you refer to are known as "tear troughs".  I personally prefer Restylane for filling in this area and have very good luck with it for many years.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon

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.