Will Juvederm fill in under eye wrinkling and volume loss after a blepharoplasty that removed too much tissue?

Question

I had a Blepharoplasty a few years ago, and a lot of tissue was removed under the eye. Now, five years later, I am getting a lot of wrinkling and the under eye area seems to be sinking in, making me appear older. Will any cosmetic filler like Juvederm be helpful at this point since I have had tissue removed? I really need a good answer to this before having a major nightmare scenario.

David L. Mobley, MD, FACS · Answer

The use of dermal fillers for hollow areas along the lower eyelids is common, especially in the area sometimes called the tear trough. This is the area some people think of as the dark circle under their eye. I have used Juvederm and Restylane successfully for these hollow areas. Fat grafting may also be successful but does require harvesting of the fat from your hip or abdomen.

	Since you have had surgery one key issue is how thin is the remaining eyelid tissue. If I were seeing you as a patient I would carefully examine this area since anything placed in this area is more likely to show or not look natural if the remaining skin/tissue is thin.

	My first choice to try to fill this area in some would be Juvederm since it has a smoother, thinner consistency. I think it would be less likely to cause lumps. Although if they occur, lumps can be dissolved rather easily with Hyaluronidase.

	Since you also note wrinkling in this are sometimes the addition of a laser treatment is necessary to get the best results. My preference for this area is the Active FX Fractional CO2 laser.

	Often the best results in your situation is when you combine these two treatments since the laser essentially shrink wraps the skin slightly to improve the wrinkles while the filler helps fill in the concavity.

	As you might have guessed this problem is not easy to fix. I spend a good bit of time explaining the treatment to patients before proceeding since sometimes more than one treatment with the Juvederm is needed and lumps are possible.

	Overall, though, success is likely.

Ron Shelton, MD · Answer

Although it is an off-label use, Juvederm or Restylane is being used by many physicians for this exact indication. It is placed underneath the muscle so that the thin skin of the lower eyelid wouldn&rsquo;t show lumps of the filler.
The overlyling skin might improve very little in texture, but this can be improved with Portrait plasma or laser resurfacing, such as Fraxel.

Michael A. Persky, MD · Answer

Hi Venus,
Restylane is an excellent filler for filling lower eye lid hollows, even in patients who have a history of blepharoplasty. 
The lower eye lid area is very delicate and requires an experienced cosmetically trained physician. 
Good luck and happy holidays.
Dr. P

Kris M. Reddy, MD, FACS · Answer

Dermal fillers can be performed to improve the hollow areas of the lower eyelids. Restylane is probably the best product for this area, but juvederm can be used as well. The risks are plentiful so it should be only done by expert injectors who are experienced in this use.

Pat Pazmino, MD, FACS · Answer

Juvederm is an excellent hyaluronic acid based injectable that can be used effectively for facial contouring.

	Juvederm is commonly used around the lips, the smile lines, the marionette lines, under deep wrinkles, under deep scars, and even under the area of the eye.

	However, keep in mind that the area under the eyes has some of the thinnest skin in the body and can bruise very easily because of the high concentration of blood vessels. For this reason it is essential that you work with a board-certified plastic surgeon who has experience in blepharoplasty, facial rejuvenation and with dermal fillers. Such an expert is very familiar with the anatomy of this area and will be able to inject the Juvederm in the correct location and in a smooth fashion.

Will Juvederm fill in under eye wrinkling and volume loss after a blepharoplasty that removed too much tissue?

Answers (10)

Answer: Juvederm After Blepharoplasty

Answer: Juvederm After Blepharoplasty

Answer: Using Juvederm under the eyes

Answer: Using Juvederm under the eyes

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Will Juvederm fill in under eye wrinkling and volume loss after a blepharoplasty that removed too much tissue?

Answers (10)

Answer: Juvederm After Blepharoplasty

Answer: Juvederm After Blepharoplasty

Answer: Using Juvederm under the eyes

Answer: Using Juvederm under the eyes

Browse related questions

Recommended reading

Everything you need to know about Juvederm

Our mission is to create a world where every investment in modern beauty is Worth It.