Juvederm for Under Eye Bags?

Can I use Juvederm for puffy bags under my eyes?

Doctor Answers 2

Juvederm for under eye bags?

Dear C,

To understand WHY certain treatments work and others do not - you must understand the structural anatomy of the lower lid. I'll try to make as this as little mind numbing as possible.

The lower lid bagginess seen with increasing age actually represents the forward movement of poorly restrained fat that in youth sits under the eyeballs, projecting them out of the eye socket. As we age, the forward soft tissue nets holding this fat become weak. The eyeball (IE peri-orbital) fat falls forward creating 3 deformities of aging;
1. more sunken eyes
2. puffy, baggy lower lids (filled with the periorbital fat)
3. accentuation of the crescent line BELOW the lower lid (the so called Tear Trough or nasojugal line). This line represents a dense ligamentous attachment of the lower lid to the bony lower rim of the eye socket. Since it is immovable, any fat pouring or hanging over it, and the drooping on the cheek below it (creating the nose to corner of mouth (nasolabial) lines) greatly accentuate it.

The WHOLE areas can be addressed with several procedures:
1. To blurr and de-accentuate the sunken tear trough, it can be filled just at the bony level with a filler. In my experience Restylane and Juvederm have been equivalent.

2. If you want the lower lid bagginess to be further flattened, you MAY benefit from a procedure which either removes or repositions the periorbital fat back into the lower eye socket (transconjunctival Blepharoplasty).

3. Finally, if you really wanted the NL folds to be smoothed, the cheek would need to be lifted to its youthful position with a vertical mid face lift.

All of these procedures are complementing of one another and are associated with different risks. You would need to decide what truly bothers you and how much correction you really need.

Hope this was helpful.

Peter A Aldea, MD, FACS

Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Juvederm for under-eye areas

In general, fillers are not beneficial for under-eye bags but can help fill in the under-eye "hollows." Furthermore, I prefer Restylane for the lower eyelid area because its behavior is more predictable than Juvederm in this area. If you have volume loss below the under-eye bags, Restylane can be used to fill this transition zone. I would consult with a board certified facial plastic surgeon to explore all your options including lower lid blepharoplasty with fat re-positioning.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

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