Non surgical options for lower lid retraction with hyaluronic acid gel (Restylane)? (Photo)

Question

I have only 1-1.5 mm retraction of lower eyelids (after blefaroplasty) without any functional problems. I concerned about only esthetic side. I figured out, that Restylane (hyaluronic acid gel )-is alternative to a surgical approach. Any more surgestions? How long the effect will persist?

Mehryar (Ray) Taban, MD, FACS · Answer

Filler injection will NOT provide adequate correction and it is short-term. See my page on eyelid retraction surgery which also includes a video testimonial from a patient who tried fillers many times prior to finally correcting it with surgery.

Kenneth D. Steinsapir, MD · Answer

This requires a surgical reconstruction to make a long term difference here.  The infracillary incision injures the motor nerves to the muscle that helps hold the eyelid in place against the eye.  This does not recover.  Simply tightening the lower eyelid can actually make the situation worse by further pulling the lower eyelid under the curvature of the eye.  Think about tightening a belt on a full belly.  The belt ends up under the curvature of the belly.  To deal with this issue, a number of specialized strategies are used including rim implants to support the cheek soft tissue, hard palate graft to control the shape of the lower eyelid and, yes, canthoplasty.

Aldo Guerra, MD · Answer

Restylane is not indicated for this under FDA guidelines, so it would be off label use. Restylane might be too lumpy in the eyelid itself. Have a formal consultation with an experienced injector and consider a uniform small particle filler like Restylane Silk or Belotero. You should expect only temporary improvements.Best wishes, Dr. Aldo

Chaneve Jeanniton, MD · Answer

Yes, Restylane filler can be used as a nonsurgical treatment for mild lower eyelid retraction.  The filler acts to expand and support the lower lid into a better position.  This is definitely an advanced technique and results are temporary.  Please see an experienced oculoplastic surgeon for a formal consultation.

Val Lambros, MD, FACS (retired) · Answer

this has been reported to work though I don't have experience with it. It is easy enough to do and it can be completely reversed if you don't like it so I think it would be worth a try if you go to someone with some experience.  Retsylane lasts a long time, years under the eyes. Don't use Juvederm, Radiesse or Voluma.

Non surgical options for lower lid retraction with hyaluronic acid gel (Restylane)? (Photo)

Answers (5)

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