Is It Ok to Use Restylane 18 Months After Using Juvederm Under the Eyes

I had juvederm injected under my eyes 18 months ago, about 3 weeks ago I had the dissolving agent injected to remove small bumps, it seems to have removed the remaining juvederm leaving me with dark circles and bags under my eyes again. I am considering using restylane instead. Is this recommended ? Are there any side effects that can happen my mixing the two fillers?

Doctor Answers 12

These products are mixed all the time.

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It is a shame that enzyme meant to shape a service actually removed the treatment.  Unfortunately treating this area is a bit of an art form.  You might consider seeking out other potential injectors.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restylane 18 Months after Juvederm in Lower Lids

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I prefer to use Restylane rather than Juvederm in the lower eyelids because the Juvederm is hydrophilic, meaning it tends to attract and hold water from  the surrounding tissue fluid causing prolonged post injection fullness. I would not literally mix Restylane and Juvederm, but you can have Restylane injected at this time even if there is a small amount of Juvederm in the eyelids.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Restylane under eyelids

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Restylane is my filler of choice for the tear troughs and lower lid region.  There would be no contraindication to your undergoing treatment with Restylane now that the Juvederm has dissipated.  If you are unhappy after trying the Restylane, then it may be time to discuss a lower lid blepharoplasty with your plastic surgeon.  Best of luck!  Dr K 

Using Restylane under the eyes

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Restylane & Juvederm are both made of hyaluronic acid, a natural component of the skin that forms part of the extracellular matrix of the dermis so they can be mixed without any problems. I too prefer using Restylane for under eye injections. When fillers like Restylane are used in the under eye area they need to be injected more deeply so there should be minimal chance of your developing small bumps like you did  before. Since every face is different, the experience and technique of your physician injector is the most critical part to your achieving a beautiful, natural result. Always ask to see before and after pictures of patients they have personally injected.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Restylane under eyes

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Restylane is my favorite for under the eyes. Juvederm can leave a purple hue as the skin is very thin here and there is no space to inject this more '":deeply". There is no problem injecting one after the other, even five minutes after, so go and enjoy. Just make sure that whoever does this is experienced. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Using Restylane under the eyes

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I'm honestly surprised that you still had Juvederm 18 months after treatment, and that you had enough left to see a difference after the hyaluronidase was injected to dissolve the remaining bumps. I don't like using Juvederm under the eyes because it can leave a bluish tint (Tyndall effect) and cause ridges. My assumption is that you had this originally and now the Juvederm is gone. I prefer to use Restylane in this area because it doesn't have these same problems. You can absolutely inject Restylane into an area that previously had Juvederm in it. The two have no problems together and are both HA fillers.

Restylane to treat tear trough deformity

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Their is no problem injecting Restylane after Juvederm since they are made from the same material. They are both HA. They both last about two years under the eyes. I like Restylane better under the eyes since it causes less swelling!

Good luck ! 

I prefer Restylane over Juvederm for hollow areas under the eyes

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Although, for most of the rest of the face I actually prefer Juvederm. Both are hyaluronic acid products (HA) but the act differently around the eyes. HA absorbs water which is called Hydrophilic. For some reason, Restylane tends to have most of the swelling in the first 2 days after injection around the eyes but not beyond. Juvederm can swell weeks to months later and this can recur. I have dissolved Juvederm under patient's eyes that were injected by other physicians up to and even beyond 2 years after treatment. Yet, this is rarely necessary for Restylane.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Juvederm vs Restylane For Tear Troughs

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Juvederm and Restylane are two different fillers made of the same basic compound, hyaluronic acid.  When used to correct the "tear troughs" under the eyes, the material must be injected very deeply .  Bumps can occur if too much material is injected or the material is injected too superficially.  The likelihood of developing these bumps can also be minimized by having the injector massage the area immediately after injection. 

Fortunately when bumps do occur, they can be dissolved away with hyaluronic acid and additional filler can be injected. There is no problem changing from Juvederm to Restylane or mixing the 2 fillers, however the risk of developing bumps is the same.  Hope you have better luck this time.

Alexander Gross, MD
Atlanta Dermatologic Surgeon

Restylane vs Juvederm under the eyes

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Restylane is made out of Hyaluronic acid which closely resembles the same substance that occurs naturally in the body.  If you already had the hyaluronase to break up the residual Juvederm, you should be fine to do Restylane.  As far as side effects from mixing filler, there should be none.  You should be able to do Restylane as soon as you can, with the same great results. Good Luck!

Philip Young, MD
Bellevue Facial Plastic Surgeon

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.