How is Juvederm Used on Under Eye Bags?

Question

I have bags under my eyes, mostly hereditary, and want to try Juvederm to reduce their appearance.Is this typically done by smoothing out and contouring the ridge that joins the bag to the rest of the face?  Or is it usually done another way?

Steven J. Pearlman, MD, FACS · Answer

Using a hyaluronic acid filler to camouflage bags under the lower eyelids is an excellent procedure for the right person. I prefer Restylane since it absorbs fluid for one to two days then settles until it slowly dissolves over the next 9 months or so. Juvederm can absorb fluid on and off for months so it's not as predictable.
The way it works is by injecting the filler on top of the bone in a hollow area called a "tear trough" under the eye-bag. This converts a convex bump (bag)--hollow groove (tear trough)--convex bump (cheek) to a more uniform contour. Sometimes the filler is used more superficially. however, eyelid skin is very thin so fillers may look lumpy if placed too superficially.

Michael A. Persky, MD · Answer

Hi Cindy,
Use Restylane to correct the hollowness of your lower eye lids.  Juvederm sometimes will attract too much subcutaneous fluid and cause unslightly swelling that is difficult to resolve even with hyaluronidase injections.
Choose your physician injector most carefully in this delicate and unforgiving area.
Be well.
Dr. P

Nissan Pilest, MD · Answer

Actually, adding more volume to an area that is already protruding could be the wrong choice. If you were only  wanting to fill a hollow, then a filler might work. If your skin is thin, Juvederm may cause a bluish colored cast as light will "reflect" from the gel. It's not the right choice for everyone. Don't jump into a filler without giving this considerable thought about what you are trying to attain.
To reduce the eye bags non surgically, I've had some great success with Fraxel Repair. That would potentially require 2 or 3 procedures, but there would be little chance of the bags returning as the skin tissue is tightened as well as reduced in area volume by the CO2 laser.
An experienced surgeon/dermatologist should be able to guide you as to whether your particular situation would benefit from a nonsurgical solution.
If you do opt for filers, I'd recommend that you have it done in stages. From your description, it sounds like you are not wanting to fill a hollow under the eye, but "add to" the bottom of the bag area to lessen the edge. Trying to do it all at once could get you some results that you didn't bargain for.

Benjamin Barankin, MD, FRCPC · Answer

Juvederm and other hyaluronic fillers are useful in reducing the "tear trough" or groove that some people have under their eyes, often for hereditary as well as aging reasons. Some people have a very large bag under their eyes (herniated fat) which may be best corrected with eyelid surgery ("blepharoplasty"). However, by putting a filler below the bag where the groove is, it takes away the shadow and makes the bag less noticeable and avoids or holds off surgery.

How is Juvederm Used on Under Eye Bags?

Answers (4)

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