Under eye filler, Restylane or Juvederm, injection location?

How come in all the videos I have seen of under eye fillers, they are injecting the filler into the fleshy area next to the nose which does not appear to need volumizing, instead of directly in the hollow under eye circle which does need volumizing? I also canceled an under eye injection when the doctor started pointing at that fleshy tissue next to my nose when talking about the injection he would do.

Doctor Answers 10

Injection of Restylane under the eyes

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 Thank you for sharing your question. Restylane is a good product to hide eyelid bags or depressions. It is an area which requires much experience to achieve an optimal appearance and to avoid serious complications. See an experienced specialist for in person evaluation and discussion of treatment plan.  Good luck,

Under eye filler

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Under eye injections are a delicate procedure. The skin of the lower eyelid is very thin and if the correct product is not used at the correct depth, a blue tint that looks like a bruise will be visible long after bruising should have resolved. Fillers need to be customized to your concerns and anatomy and not placed in the same spot in every person. In others, fillers may not be the best option and a fat transfer may be a better solution. Seek out a consultation with a Board Certified Facial Plastic Surgeon/Plastic Surgeon/Dermatologist with a high volume injectable practice. All the best,

Dr. Brace

Matthew Brace, MD
Ontario Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Filler under eyes

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each injection has to be individualized to the problem. With that said sometimes one needs to inject more towards the nose area and sometimes more towards the outer portion. The thin skin creates the dark circle and that's where one should inject. There will be less shadow effect afterwards.  

Only very experienced injector should perform this procedure. Blindness from injection into a vessel is a rare complication.

Best fillers for that location are Teosyl redensity. Belltero. Restylane silk. 

Daniel G. Kuy, MD
Cincinnati Plastic Surgeon
4.5 out of 5 stars 18 reviews

Belotero Balance Or Teosyal Redensity II Work Well For Tear Troughs, Hollows & Dark Circles Under The Eyes

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I have been injecting the under area for treating tear troughs, hollows and dark circles for over three decades since the early days with the introduction of the original Zyderm Collagen I injectable filler.  Among experienced, expert injectors, the basic rule is that you treat what needs to be treated, instead of treating everything by a cookbook approach. While I cannot make any specific comments about the videos you saw, I can say that I agree with you that only the depressed areas that require filling should be filled. While Juvederm and ordinary Restylane are often used in this region by inexperienced injectors and medspas, Belotero Balance, which would be my choice in my Upper East Side Manhattan practice, and Teosyal Redensity II, which I would opt for in my Israel satellite facility, make better choices, since they possess little to potential for giving rise to the unwanted, bluish Tyndall Effect when injected superficially into the delicate tissues under the eyes, and they do attract as much tissue fluid to it as does Juvederm, lessening significantly the possibility of giving rise to under eye swelling and bags. Best to seek consultation with a board cerrtified aesthetic physician with expertise in the nonsurgical periorbital rejuvenation. And, of course, be sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Dark Circles, Eyelid Wrinkles/Bags -- Restylane or Belotero, Laser C02/Erbium Resurfacing, Microneedling, Viva/Intensif, Fraxel

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fillers injections are customized. I suggest you see an expert to do a formal evaluation and decide what filler is best and what technique would give you a good outcome.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Under Eye Filler

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Neither Restylane or Juvederm Ultra (what most people mean if they say "Juvederm") work to fill the under eye area. They also can cause significant problems when injected in that area. The tear trough is the result of descent of the cheek or a congenital depression above one of the muscles in the area. Any filler in the area needs to be done with either Radiesse or, preferably, Juvederm Voluma and must be injected deep. If your physician is not doing this it is because of either lack of knowledge or experience. Make sure whoever you see is an expert injector in this area and can show pictures of excellent results there. (See plasticsurgerytoday.com/non-surgical/todays-liquid-lift-wrinkle-and-contour-correction/)

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Tear trough

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Usually the filler is placed along the orbital rim in a very delicate manner. Injecting very superficially may cause lumpiness and visibility.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Under Eye hollows/Tear Trough and Fillers

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Each case is different.  For some patients who have only tear trough hollows I recommend only filling that area. Many cases have hollowing of the mid-face as well and need Voluma to contour that area. This is an art and there is no one "formula" for every patient.  Please consult an expert.  Best, Dr. Green

Under eye filler location

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This area should be treated as a cheek and tear trough fill. They are connected and need to be considered together. Just filling the tear trough looks odd and doesn't look good. It should be done with Restylane and with cannulas for best safety and less bruising.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Injection location for under eye filler?

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Thank you for sharing your question.  In most instances correction of undereye hollowness does require placement of filler from the nasal side of the eye out towards the outer portion in order to achieve a smooth contour and transition to the upper cheek.  This is clearly patient dependent however, as some have more hollowness along this region, while others do not.  As for filler I would recommend the hyaluronic acid based dermal fillers such as Restylane, Volbella, or Belotero.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.