Radiesse for Tear-trough Area?

I'm a 25 year old, female and since I turned 22, I noticed that my uppermost-cheek/tear-trough area is starting to flatten. This problem emphasizes dark circles around my eyes and makes me look tired.

How many cc's of filler would it take approximately to correct this? My problem isn't severe and I have good width across my cheekbones, but I'd like an improvement for this particular area. Can Radiesse be used for this area?

Doctor Answers 10

Avoid Radiesse under the eyes

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The best filler for the tear-trough deformity is either Restylane or Juvederm. I would recommend using less than 0.5 cc in each tear-trough. It will usually last a year and ofter times longer. The other nice thing about Restylane and Juvederm is that they are reversible. Radiesse is not recommended under the eyes, as it can be visible and lumpy.

Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Lower Eye Lid Hollows...Use Small Quantities of Restylane

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Hi Rainy,

Do not have Radiesse placed in the delicate area of hollowness in the lower eye lid.  Restylane is the best product to use in this area, and it should be used in very small amounts, you can always have more added if necessary.

Choose your injecting physician most carefully.  Be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Fillers for the tear trough area

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The hyaluronic acid fillers are generally more forgiving in the tear trough area and safer than Radiesse because the material can be dissolved by hyaluronidase if needed. My preferred hyaluronic acid filler is Restylane (seems to stay in place better than Juvederm in the tear trough area).

I would generally recommend Restylane for the tear trough area; however, results with Radiesse are very technique-dependent and practitioner-dependent. Contour irregularities and nodules can be avoided by placement of the material in small volumes, deep to the orbicularis oculi muscle (next to the periosteum), and with thin, evenly distributed threads of material rather than boluses. The procedure can be staged as well to ensure that over-filling does not occur.

As always, you should be educated about the potential common and serious complications before undergoing any procedure. Your choice of injector is at least as important as your choice of filler material.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist


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1)  Radiesse should not be used in the tear trough.  This is a tricky area and you want the most forgiving filler.

2)  In Manhattan, we use very small amounts of Restylane injected deeply into the tear trough.

3)  You are very young for any filler.  Go slow.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Hyaluronic fillers for tear trough

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The filler of choice for the tear trough area is a hyaluronic acid, such as Restylane or Juvederm. Usually a 1 cc syringe is enough for both sides. They last about 6 months and great results can be achieved with them. I do not recommend Radiesse in that area. Make sure the physician has experience injecting the tear trough before you have it done.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

Undereye Filler Treatment

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The tear trough areas, right under your eyes, is very delicate. I would recommend that you try a small amount of Volbella, which is a very fine product. Volbella is a Juvederm product. The amount you would need really depends on an in-person consultation with your experienced medical injector.

No to Radiesse under eyes

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As would many experienced injectors in this area, I would recommend the use of Restylane in the tear-trough area. Restylane works very well to achieve desirable results in this delicate area of the face where the skin is thin. It is extremely important to consult with an experienced physician in your area. Radiesse is a thicker filler and can be used to achieve good results in the cheek and lower facial regions.

William P. Mack, MD, PA
Tampa Oculoplastic Surgeon
5.0 out of 5 stars 46 reviews

Which filler for tear trough

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I would personally not recommend radiesse for the tear trough (partly because its not reversible if there is a problem, and partly because it is too thick and can be lumpy). My preference in order would be restylane, restylane fine lines, and then juvederm ultra. All of these hyaluronic acid fillers have been widely used in this location and give natural and long lasting results. Make sure to have an experienced and highly trained injector treat you in this very delicate area. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Radiesse or Fat

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I like Dr. Beraka because I think he's safe and conservative, but I have to disagree in this case.

First, I think that Radiesse is a much better filler in the tear trough area than the more superficial fillers, such as Restylane or Juvederm. But the filler has to be placed deep, just above the periosteum or tissue over the bone. And care must be taken to not get into the orbit.

Fat grafting or fat injection as some call it is also a great alternative. Again, the fat is placed deep, close to the bone. If there are lower lid bags than a lower lid bleph with fat redraping is a good idea.

See several surgeons first.

Be very careful with fillers in the tear trough

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I have just finished chairing a major cosmetic meeting that we have each year in las Vegas and it is apparent that there are potential problems in up to 10% of those who are injected with any substance in the tear trough. Having stated this most of the time we can reverse the Hyaluronic acid fillers. The same is not true for Radiesse.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.6 out of 5 stars 19 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.