Do 2 Syringes of Juvederm Seem Excessive for the Tear Trough Area?

Ever since rhino, I have basset hound eyes. I recently had Juvederm for the tear troughs-1 whole syringe for both. Results looked great for 2 weeks; then they returned to baseline. PS says he would use another whole syringe. (I asked for a little help with outer edge of orbital rim, too.) From what I've read,1 syringe seems to do the trick. I am so scared. One PS destroyed my face with rhino, & now I can't even rescue my eyes. The filler already bulges when I smile. Won't more make that worse?

Doctor Answers 10

Juvederm for Tear Trough Area

Thank you for your question. Under the eyes is a very delicate area due to thin skin. Only a small amount of filler should be injected to avoid overfilling.  Although, sometimes an individual may need more fillers to get a full correction.  I would recommend being treated under the supervision of a Board Certified Dermatologist or Plastic Surgeon for safest and best treatment option. I hope this helps.

Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

2 Syringes of Juvederm Too Much for One Tear Trough?

    If you are not satisfied with the volume improvement with one syringe, then another may be injected.  Every volume deficit is different and patient needs and desires are unique.  I would say that you may want to consider Restylane in the future, but this depends more on the skill of the injector than the product.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

How much Juvederm is needed for tear troughs?

It depends on the person, of course. But 2 syringes is pretty typical if there is a significant hollowing in that area.  Without a photo it's hard to guess. It is important to have the placement correct.  Another thought is considering a different product for that area.  I have found the Restylane or Belotero may lay a little better in the thin skinned areas. These are both softer than Juvederm and may less likely to swell up or show through the skin like Juvederm can do when placed too superficially

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

How much filler needed for tear troughs

Every person is different and it really depends on how deep your tear troughs are. That said, in 90% of cases, I find 1 syringe of Juvederm or Restylane to be sufficient. Best to go slow since you can always add more if its not enough.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.9 out of 5 stars 49 reviews

Juvederm for under-eyes and tear troughs

Everyone requires a different amount of product depending on how much augmentation is necessary. It will certainly vary if you are treating more than one region (e.g. tear troughs, orbital rim, etc.). In general, one syringe is usually enough for the tear troughs. Most commonly, I will use Restylane Fine Lines under the eyes as Juvederm tends to draw more water and cause a bit of a puffy appearance.

Best wishes,

-Dr. Jamil Asaria

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 131 reviews

Tear trough filler

I'm a HUGE fan of Juvéderm, but I don't use Juvéderm in the tear trough area. Without seeing your photos, I can't specifically comment about what you need. But, in general, regarding tear trough area filler I:

  • use a hyaluronic acid filler only
  • prefer Restylane or Belotero
  • don't use Juvéderm because it draws a lot of water to it, more than the other HA's
  • don't use Radiesse, which is not a hyaluronic acid filler
  • don't use Sculptra in the tear trough area, which is a stimulator, not a filler
  • am conservative, and prefer more than one session to get the amount placed just right; too much is worse than too little
  • recommend seeing a physician who is very experienced with this more advanced area for filler placement

Kimberly Finder, MD
San Antonio Dermatologic Surgeon
4.7 out of 5 stars 62 reviews

Amount of Juvederm for the tear troughs

Without seeing you, it is impossible to know how much filler should be used for the tear trough area.  Juvederm can cause excessive puffiness under the eyes if too much is injected since it retains quite a bit of water.  You should wait at least another month to see the final result.  It is easier to add more filler later rather than have to remove it if too much has been injected.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Filler along orbital rim tear trough

Of course it depends upon the deformity but I usually use one between both lower lid tear troughs and prefer restylane diluted because this area is very sensitive to lumps.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Two syringes may be excessive


Thank you for the question.  Two syringes is quite a bit for the tear trough area, however your plastic surgeon may in fact be injecting it beyond the tear trough area.  I think one of the key points is that the Juvéderm is already visible when you smile.  Injecting more product me make this issue more visible.  Of course careful evaluation would be necessary to provide a more accurate answer.  I would definitely bring this question up with your plastic surgeon.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Amount of Juvederm for tear troughs

All treatments should be individualized to each patient, so some patients will require more Juvederm than others to achieve the desired result.  Without seeing you, or pictures of you, it's impossible to judge how much Juvederm would be recommended to treat you.  Having said that, I do feel that two syringes of Juvederm does seem like large amount to treat only the tear troughs.  If the area of depression below your eyes was fairly large, then it's possible that more than usual was needed.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.