Syringe or Cannula? Which is Better for Injecting Restylane in Tear Trough? (photos)

I'm interested in getting Restylane in my tear trough area. I have hereditary dark circles and some thinning in the skin. Which injection method is better/safer? Syringe or Cannula?

Doctor Answers 18

Syringe or Cannula.

Both Syringe and Cannula are excellent methods to inject Restylane in the tear trough. This is an off-label injection. I generally prefer a needle to a Cannula. They both actually use syringes, but it's a matter of whether or not you use a needle. The Cannula can be considered by some physicians to be less traumatic, but I feel it really is a question of the injection technique. You can equally inject with a needle. I feel that a needle produces more collagen stimulation, and you can get into different planes more easily. The important thing is which one the doctor is more comfortable with and is more experienced using - particularly in the eye area. That said, both a very small needle and a very small cannula can be used.

New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Be careful with tear trough injections! You may get the swollen look.

I think tear trough injections are done so often without any regard to aesthetic value.  While a few may benefit, most will only regret making this choice.  So, why do a lot of cosmetic surgeons readily inject the tear trough?  Because people, like yourself, are asking for this specific treatment.  I think it is best to have your face evaluated by an experienced board certified plastic surgeon.  Why?  Because plastic surgeons spend the most of their training and practice in learning and knowing how to change the facial anatomy to more aesthetic and natural proportions.  Your one photo is not enough to know that you would benefit from augmenting your cheeks rather than filling in the tear trough areas or both. It's much more complicated than people realize.  This is why there are more and more awkward 'swollen' looking people these days. The syringe vs. cannula is more an argument of safety.  Doctors, who don't know the anatomy so well, will say cannula is safer.  Doctors, who know the anatomy well, will say it doesn't matter.  And remember, good doctors will not  do something that is either not of aesthetic value for you or take risks that are greater than the benefits.  Good luck!

Tae Ho Kim, MD
New York Plastic Surgeon
4.5 out of 5 stars 12 reviews

Microcannula for Tear Trough Treatment

I prefer using a microcannula when injecting filler, especially under the eyes since this is such a delicate area.  A needle is used to create an insertion point and then the microcannula is used to inject the filler.  This allows for careful and precise injection of the filler.  Using a microcannula reduces the chance of bruising and makes for a more comfortable experience.  I suggest finding a doctor who has experience using microcannulas and has great before and after results.  I hope this helps!

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
4.9 out of 5 stars 47 reviews

Injection technique with a cannula

Injection technique with a cannula will dramatically reduce swelling and bruising in this area than the traditional syringe needle injection technique.

Lenore Sikorski, MD
Orange County Dermatologist
4.3 out of 5 stars 24 reviews

Syringe or Cannula? Which is Better for Injecting Restylane in Tear Trough?

In general, a blunt cannula is the better option for this area of the face. Using a blunt cannula will give the following advantages:

1) Reduced risk of bruising
2) Increased safety for the patient

Restylane is a great filler for the tear trough, and will yield a great result when the injections are performed properly by a specialist. I would recommend seeking the advice of the following board certified physicians when having treatment with Restylane:

1) Dermatologist
2) Facial plastic surgeon
3) Plastic surgeon

I hope this information helps, and I wish you the best of luck. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Restylane in the Tear Trough

I like to inject Restylane with a cannula into the tear troughs of my patients; I find that it causes less swelling than Juverderm and has more natural look than Belotero.

When I use a cannula there is generally one insertion point. When you inject with a needle there are several injection sites causing more possibility of swelling, bruising and lumps and bumps under the eye.

I think the cannula method under the eye is superior to the needle method, the end result is much smoother with less bruising and swelling.

It is best to consult with a Board Certified Dermatologist to with plenty of experience treating under eye hollows.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 22 reviews


A cannula is a blunt needle inserted through a tine whole made by a sharp needle.  It is generally thought to be safer in this area.  The cannula is on the end of the syringe.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
4.5 out of 5 stars 25 reviews

Syringe Is More Precise For Placing Filler In Tear Troughs

I have been injecting tear troughs for over twenty years, dating from the early days using the original Zyderm collagen filler. I have great experience in using both cannulas and needles for treating this delicate region and have found that properly chosen needles can yield excellent results with a side effect profile--i.e. likelihood of swelling and bruising--that is in no way significantly inferior to that achieved with cannulas.

I prefer to use Belotero Balance, rather than other fillers, including diluted Restylane (which is often chosen for under the eyes), since this product does not result in the unwanted, bluish Tyndall Effect that can be seen when other fillers are injected too superficially or within the delicate skin under the eyes. I also use only one entrance site per side, just as with cannulas, that is numbed beforehand (making the whole treatment painless) and can reach all areas using a 1.5 inch needle. And since the needle is more rigid than a microcannula, the material placement can be better controlled--meaning a better outcome.

It is especially important to seek out a board certified aesthetic core physician with extensive experience and expertise in treating this more demanding location.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

Needle or cannula for tear trough injections?

It is difficult to say that a microcannula is better than a needle for tear trough injections, or vice-versa.  It is probably fair to say that a microcannula is a little safer, somewhat less likely to cause bruising, and possibly a little less uncomfortable for the patient, and makes the procedure longer,  but it can be more difficult to place the product exactly where you want it with a microcannula than with a needle, and with a microcannula you have a little nick in the skin at the entry point(s) that may take one to three days to heal.  

An advanced injector would probably feel comfortable working with either, and would decide which to use based on your anatomy, your bruising tendency, how tolerant you are to developing some bruising, and your ability to tolerate discomfort (for a procedure that is generally not very painful in any case). And even after a microcannula injection, a needle injection is often necessary to fine-tune the treatment.

It is important, I think, is to find an advanced injector who is highly experienced with tear-trough injections and is comfortable with both approaches whom you trust to choose the best approach for you. You are likely, then, to be happy with both the procedure and the results.

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 8 reviews

I Prefer Using a Cannula for Injecting Restylane in the Tear Trough

While both a needle and a cannula can be used to inject the tear trough, I prefer the cannula.  In my mind, using an instrument that is blunt has clear advantages to a sharp needle.   They include:

1)  Decreased risk of bruising
2)  Improved safety
3)  Less needle sticks in a sensitive area of the face

As long as the product is place deep, I have never seen the bluish color from injection with Restylane.  Currently, I only use Restylane in the area and I get the best and longest lasting results in this area with that product.

I hope this helps.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 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.