Long-term use of Restylane or other under-eye fillers - risks.

Question

I have read several threads here where plastic surgeons insist Restylane and other fillers are completely safe over the long term. Then I found some research. Why are none of the plastic surgeons on this forum mentioning these risks? There are other articles outlining risks in addition to this one.

Alexander Rivkin, MD · Answer

Hi and thanks for your question. Injecting hyaluronic acid fillers in the under eye area is a procedure that is very safe and extremely effective. Filling a hollow tear trough area with filler is not only easier, quicker and cheaper than surgery, the results are better because the procedure is more precise. We have been performing this procedure daily in our clinic for 14 years. There are always risks with any filler injection - bruising, redness, lumps, etc. Injection into the tear trough, if performed by an experienced professional is no more risky than any other area. In a wide ranging study of all known cases of blindness from fillers, the under eye area was safer than the nose and between the eyebrows when it came to that extremely rare but devastating complication. By the way, the authors of the study saw less than 100 of these cases reported over the last 100 years. That means the risk is less than the risk of flying in a plane or driving in a car.Tear trough injection is not only safe, it is very effective over a long range of time. I specialize in these kinds of procedures, so I prepare Juvederm specifically for the under eye area. By using this preparation, I have been able to get the results to last for years. I routinely promise 2 years, but I have seen patients 6 years later where the filler is still there and looking great.I have never seen a single patient with a problem from long term use of fillers under the eyes. Hope that helps.

Andrew Pichler, MD · Answer

Thank you for your important question. First, restylane itself is a hyaluronic acid and that substance in itself is safe. The risks arise from the injection itself. So it's technique dependent. That is why it is so important to have it done by well qualified and trained providers. Blindness is extremely rare bit can happen if a blood vessel is injected that feeds back toward the eye. And this could actually happen from injections anywhere in the face not just close to the eye. Repeated injections can eventually cause scarring and that can lead to deformity. Again , these are very rare but unfortunately rarely reported and so your question is appreciated.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  I have at least since 2008 on this website and in my blocking cautioned people about the risk of filler injections into the eye.  Cases of blindness have occurred.  In addition most patients that I see have had their fillers injected into the wrong area which makes their deep depression underneath the eyelid look worse. Long-term repeated injections through the delicate eyelid skin and muscle has to create scarring and eventual bad effects.
I believe the reason that so many people recommend fillers underneath the eyelid is that most of these doctors are medical specialists who were not able to do the proper surgery. The only effective permanent solution to correct deep depressions underneath the eyelid underneath puffy eyes were patients with dark circles is a procedure called a trans-conjunctival lower blepharoplasty with arcus marginalis release and fat grafting.

Long-term use of Restylane or other under-eye fillers - risks.

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Long-term use of Restylane or other under-eye fillers - risks.

Answers (3)

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Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.