Restylane or Restylane Silk for my under eye hollows?

Question

Which is more effective in correcting tear troughs? Which lasts longer?

George Yang, MD · Answer

Hi Baileysmith123,Restylane has been used longer for tear trough/under eye hollow correction.  This is an off-label use for Restylane which is used on-label for smile line correction and lip augmentation.  In my experience, Restylane in the lower eyelid area lasts about 12-18 months for my patients, and sometimes longer.  When I first starting injecting Restylane in this area, I told patients that it may last 4-6 months since this is typically how long it lasted in the on-label areas which have much more movement.  Surprisingly, most of the patients did not come back for about a year or longer, and if they do have a touch up, it is usually half as much filler as they did the first time.Restylane Silk is softer and may not last as long, but since it is recently approved filler only time will tell if it lasts as long as Restylane in this area.  Ideally, the filler is injected deeper under the muscle which should prevent it from getting a bluish tinge on the skin.  This happens because the skin is very thin in the lower eyelid area, and it is injected between the skin and the muscle.  The filler is on top of the muscle so the blue tinge shows through the skin.  If the filler is under the muscle, then the muscle is directly under the skin and does not look blue. Restylane Silk and Belotero are designed to be used much closer to the surface of the skin without the skin turning blue (Tyndall effect).  But if the injector is injecting the filler above the muscle, in my opinion, this is anatomically incorrect.  Whatever fat loss has occurred to cause the under eye hollowing is from fat loss under the muscle, so in my opinion, it makes more sense to add filler in the area where the volume was lost, instead of injecting the filler in a non-anatomic area which did not have fat there originally.Please visit my web reference link below to see an example of lower eyelid filler using Restylane.I hope this makes sense and good luck on your cosmetic journey.Best,Dr. YangP.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.P.P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Nima Shemirani, MD · Answer

Hi @Aapgh412! I recommend Restylane or Belotero to treat the tear trough. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

I love voluma for long lasting results under the eyes, silk and belotero for more fine contouring of this area but they last much less long.  restylane is my least favorite option although many people do use it here.  Best, Dr. Emer.

Rebecca Fitzgerald, MD · Answer

Either filler works well. Restylane Silk is a little softer and may not last quite as long. The choice of which filler to use will depend upon several factors that might include the extent of the tear trough hollowing, your skin thickness and how the tissue beneath the hollowing provides support.It's not always the case, but picking a single "problem" area to correct may not give the best overall results. A personal visit with the doctor you've selected will be educational in terms of fillers and your particular circumstances.By the way, patients love this treatment. It's an excellent way to look refreshed immediately. Take care when choosing a physician. This is one area you'd not want to take risks.

Michael A. Zadeh, MD, FACS · Answer

Hi Bailey. Restylane, Restylane Silk, and Belotero are a few hyaluronic acid fillers that work very well to treat the under eye hollows. Fillers in this area usually last from 6 months to a year. An experienced physician injector will be able to determine which filler is best for you during an in-person consultation and evaluation. Hope this helps answer your question.

Harold J. Kaplan, MD · Answer

Hi Bailey. There are a number of products that will work in this area and the choice of product depends largely on what the injector is comfortable using.  Restylane, Restylane Silk, Voluma, Juvederm and Belotero are all products that can be safely used.  Of greater importance is the quality and experience of the injector.See below for before and after pictures of Restylane injections for hollows under the eyes for our Los Angeles patients.

Michele S. Green, MD · Answer

I prefer Restylane or Belotero for the delicate under eye area.  Restylane will last longer than Restylane Silk which I use more for the fine lines around the mouth with great results.  Best, Dr. Green

Daniel J. Ritacca, MD · Answer

I prefer Restylane in the tear trough region and Restylane Silk for the lips. It is also important to meet with an experienced injector to discuss your options and what is optimal for you. Dr. Daniel Ritacca

Robert S. Bader, MD, FAAD · Answer

Restylane is my product of choice for under-eye treatment of bags.  Restylane Silk is for fine lines and would not hold up as well, although can be used for fine lines under the eyes.I have used Perlane (now called Restylane Lyft) as well with great results as well.