Can You Put Filler in Entire Under Eye Lid or Just the Tear Trough?

Question

Yesterday I had .5 Restylane injected into each of my tear troughs. The injector placed it from the corner of my eye and would only fill to the mid eye area. She said you cannot place it further out toward the corner of the eye because it never works and would look lumpy. I am afraid the filler in the trough will emphasis the hollow on the rest of my under eye going out towards the corner of the eye. I wanted the entire under eye lid filled. Is this possible?

Harold J. Kaplan, MD · Answer

Hi Silky.  Restylane can be placed in the area you want it even if this injector is not able to do it.  An experienced injector will be able to place the product at the outer corners of the eye if he/she is injecting "under the muscle".  Some injectors place small amounts of the product superficially "above the muscle" and this technique limits the amount of product that can be placed and the location.  

	Find someone more advanced and you will be happy you did.  Good luck.

Nima Shemirani, MD · Answer

Hi @silky019! The answer is yes, but I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Kenneth Hughes, MD · Answer

In the hands of an experienced injector, Yes.Your provider may have not been comfortable injecting this area, I suggest you seek an experienced Board certified physician who is comfortable in their technique to ensure a result you wish to achieve

Kimberly Butterwick, MD · Answer

You don’t want to create an “eye bag” look so the best area for correction in the lower eyelid area is the tear trough area. This is a specialty area so find a provider with A LOT of experience.

George T. Boris, MD, FRCS · Answer

I have had positive results when Restylane is placed properly (deep). Every physician has their own comfort level. If they are not comfortable, I would advise you to go to someone who is. If you are in the LA area, I or any of my colleagues would be happy to help. Best of luck!

Mehryar (Ray) Taban, MD, FACS · Answer

The answer is yes but only the hyaluronic acid gel filler types such as restylane and belotero  See a physician with experience in injecting around the eyes.

Kenneth D. Steinsapir, MD · Answer

What this person was telling you is that they can't place the product successfully in this location. Generally, to not make an injector put product in a place in which they are not comfortable. You need to find a more experienced injector. We are out there.

Todd Christopher Hobgood, MD · Answer

Hi and thanks for the very good question.  There are two very good points and a cautionary consideration here.

	First, with experience and the correct technique, you may be able to inject that area of concern over the outer eye.  In cases with minor volume depletion, using a cannula for safety and injecting under the eye muscle (orbicularis oculi) is very helpful.  If you need quite a bit of volume, sometimes moving on for surgical fat transposition makes more sense.

	Second, it is very reassuring that we have an enzyme to dissolve hyaluronic acids available just in case.  Certainly this is a last resort, but is awfully nice to have as a back door in case of some minor irregularities exist after your treatment.

	Caution- this is all off label, and the surgeon really must have a thorough knowledge of the anatomy as well as quite a bit of experience for this to be a very comfortable and beautiful outcome.

	Free advice: Under correct by 20% and you will be perfect in the end!

	Best regards, 

	Todd Hobgood, MD

	toddhobgood.com

Steven Wallach, MD · Answer

Filler can be placed along the tear trough by experienced injectors. This is done quite commonly with dilute restylane.

Mark Taylor, MD · Answer

Restylane can be artfully placed in the tear troughs and in the lateral hollows. An experienced injector can fill all of the hollowness around the eyes. If you have excess lower eye bags that accent the tear trough, I recommend doing a lower eyelid blepharoplasty before injecting the hollow tear troughs. The hollowness is often gone once the lower eyelid fat pads have been removed or repositioned.

Can You Put Filler in Entire Under Eye Lid or Just the Tear Trough?

Answers (10)