Juvederm Ultra Plus for Tear Trough?

The tear trough areas, right under your eyes, is
very delicate. I would recommend that you try a small amount of Volbella, which is a very fine product, and
can help to soften the hollowness under your eyes, without leaving lumpiness. Volbella is a Juvederm product.

Thank you for your question regarding the use of Juvederm Ultra
Plus for tear trough injections.  Currently, in the United States, tear trough
injections are an off-label, non FDA approved area for dermal fillers (although
the consensus is that the recently released Ignore Volbella should have this
approval/indication by the end of this year.)
First of all, you will want to do some research and find an
experienced, highly skilled injector who has extensive knowledge of facial
anatomy and safely performs tear trough injections on a regular basis.
 The skin surrounding the eyes is very thin with many blood vessels and
nerves and carries a high risk for bruising and other complications. 
In our office, we first perform a comprehensive consultation and
examination for each patient to determine if she/he is a good candidate for
tear trough correction, or would be best treated by surgery, lasers, or other
procedures with or without filling. We perform tear trough injections using a
blunt-tipped cannula and injecting deeply (right over the bone) and minimally
under the muscles as we believe this is safest for the patient and provides the
best outcome. We recently have transitioned to Juvederm Volbella as it has less
swelling and is thinner and less visible but with its increased crosslinking
and provides a very smooth, long-lasting, natural looking outcome.
To emphasize this point, we tell our patients its all about a
natural, proportional result.  Proper Botox and filler should not be seen
or felt and loom natural.
We are one of the top injection practices in the US and In
addition to being proud of our Allergan "Black Diamond" status,
(making us one of the top 1% of injection practices in the United States), we
are privileged to have 2 Allergan national trainers on our staff with all of
our expert injectors having extensive training both internally and nationally.
Helping our patients safely and effectively achieve their aesthetic goals is
our highest priority and we are very grateful for their trust and loyalty!
 

It is my opinion that Juvederm is not the best product for the tear troughs because it is thicker.  Restylane or Belotero are a better choice because they are softer and lay smoother under thin skin such as tear troughs

I find the best filler for the tear trough to be Restylane.  In general, Restylane is a great filler to improve the following areas:

1) Tear trough
2) Marionette lines
3) Nasolabial folds

 

I do not use using Juvederm Ultra Plus for the tear trough because I feel it is too watery and can swell more than the other fillers. Overall, it depends on the preference of the physician and you may find that one may prefer one filler over another for a certain area. Thank you and good luck!

In general, I find Juvederm products to be too hydrophilic for predictable tear trough treatment. Using Restylane and a cannula technique, I fill 4-5 tear trough patients per day, and have excellent predictability.

My preference is for Restylane under the tear troughs approximately 1/2 syringe under each eye for a total of 1 syringe.  Restylane is a bit of a firmer filler over Juvederm whereas Juvederm is softer and better for areas like the lips, and lower face.  Juvederm Ultra Plus would seem to be too thick to use in the tear troughs in my opinion.  Being that one of my goals when filling the tear troughs is to build up the orbital rim using a deep fill method, having the firmer Restylane makes this easier to accomplish.  As an aside, we have started to use Belotero Balance in combination with the deep Restylane along the orbital rim.  We inject it in small volumes just subcutaneously as an added fix for some of the superficial lines around the eyes.  Belotero can be used here because it does not have the "tyndall effect" or bluish discoloration of other hyaluronic acid fillers like Restylane or Juvederm. 

While juvederm is possible, my preference is restylane. This is an area with considerable potential for complications so ensure that only an experienced and expert physician injector performs the treatment.

Juvederm Ultra Plus is actually very thin and cross-linked for extra smoothness. However, it is NOT my filler of preference under the eyes. Sometimes Juvederm under the eyes can cause the Tyndall effect, a bluish-whitish translucent tinting, caused by the coloring of the Juvederm itself. Even though the particle size is a bit larger in Restylane, the coloring is much preferable. There are also smaller syringe sizes of Restylane available so it's easy to get one smaller syringe done, if you are worried about overfilling and then add a second if you need more. I will say that most of the time, one syringe of Restylane 1ml is great for under the eyes, but if you wanted, you could do a smaller syringe.