How is Juvederm Injected Best for Under the Eyes?

Is Juvederm best injected deeply or just under the surface of the skin for the hollows under the eyes/tear trough area? Is one less likely to created a baggy look? Is a numbing cream sufficient for painless injections or are numbing injections necessary too? I'm trying to locate a doctor in Orange County who won't create under eye bags but with a minimal amount of pain.

Doctor Answers 12

Juvederm for the lower eyelid tear troughs

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Juvederm to the tear troughs does have a learning curve associated with it. Injecting deep with no traction on the skin is key and I try to do as little superficial injection as possible. I also no longer inject and automatically massage as I used to do. If it looks good, I don't massage at all.

Also, the patient selection is key as older and thin skinned patients do less well with any injections to the tear troughs.

Deep Juvederm injection for dark circles under eyes

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Any hyaluronic acid dermal filler injected in the "tear trough" area under the eyes should be injected under the muscle (deeply) to avoid lumpiness at the surface of the skin. As mentioned, good results in this area is very technique dependent. Numbing cream is sufficient for this treatment.

Our office is located in the city of Orange, right behind Children's Hospital and we would be happy to see you for a free consultation regarding the procedure. Visit our website link below for before and after pictures of this procedure. As an aside, we use Restylane in this area and not Juvederm.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Restylane better than Juvederm for under eyes.

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1) I think Juvederm is great, but under the eyes, I think Restylane is less likely to create bumps. This is a very trick area. The filler should be injected deep, and in very small quantities.

2) Local anesthesia should be injected, because it also constricts the little blood vessels, and makes for less bruising.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Juvederm around the eyes

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If you inject the eyes just under the skin around the eyes, it is much more likely to be lumpy than if you inject right on top of the bone. It also hurts much more superficially. My PAs are not allowed to inject there, only me. This is because I feel that it is really good to have done the surgery, and to know the anatomy very well in this area before injecting - another reason that a Board Certified Plastic Surgeon, and a member of the American Society for Aesthetic Surgery, should be your choice to see you. Look carefully at credentials before you go in.

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

Juvederm is used off-label in this area. If I am...

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Juvederm is used off-label in this area.

If I am treating fine lines, then I will very gently and in small amounts inject it underneath the skin and then massage it in so it does not create lumps. If it is for tear trough areas then I will inject it deeper and massage it in as well.

I find topical creams work very well if you allow them to work (30-40 minutes). I inform my patients that if they notice lumps after the swelling goes down, then they can massage it for a day or two to flatten it out.

How is Juvederm Injected Best for Under the Eyes?

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 IMHO, it's best to inject the Juvederm deeply within the lower eyelid area, just adjacent to the bone.  This avoids the numerous small vessels within the tissue and decreases to lumpy effect of the injected Juvederm.  

Under eye circles

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I prefer to use an infraorbital block so that my patients feel nothing and that way I am  able to inject in multiple planes depending on patient needs.  I dont think a great result can be achieved without doing this.


All the best,


Rian A. Maercks M.D.

Correction of Tear Trough (Nasojugal) Lines with Juevederm

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Although we may disagree on several technical points, I think most Plastic surgeons would inject the Restylane deep, on the bone along the rim of the orbit. Injecting it superficially may be associated with swelling and a blue tinge (Tyndall effect).

As regards anesthesia, I prefer to block the nerve supplying feeling to the cheeks - which totally numbs the lower lid as well. As a result, my patients feel NO PAIN when having such treatments.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Juvederm for eye hollowness

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Juvederm and Restylane both work great to improve the appearance of hollow tear trough area. These injections are extremely technique dependent. I usually inject small amounts at different levels, some deep, some more superficial. We don't do a lot of massaging. The product has to be injected well to avoid lumpiness. If it is, no massaging is necessary. Topical numbing cream works very well in these areas, so the procedure is very well tolerated.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon

How is Juvederm injected best for under the eyes?

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Juvederm is best injected very carefully and conservatively when used under the eyes.  It is best not to inject too superficial and inject minimal volume.

Fred Suess, MD (retired)
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.