Restylane or Juvederm for Under Eye Line/indentation?

im only 27 and have very deep under eye line/indentation stemming from my eye way down to my cheek. it makes my face appear to sag. for my case, would restylane or juvederm work? or wld i need a cheek lift to correct it? it doesnt have to be completely gone, but i'd like it to be much less noticeable.

Doctor Answers 18

This is not a tear trough hollow!

The line in your cheek is not the tear trough hollow.  It is called a midcheek groove.  Honestly, I would not recommend surgery on this.  I personally feel fillers are the way to go.  This can be addressed with Restylane or Perlane.  Juevederm could be used here but I am concerned about its ability to hold in this area.  

When the marketing people say it is smooth, they are describing a property of the Juevederm to spread out in the tissue.  This is not always a desirable characteristic.  The Perlane in this area can last up to two years and it is adjustable with an enzyme.  Why have surgery if you don't need it?

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Best fillers for cheeks

It is a little bit hard to tell from the photo since it isn't a close-up, but what I see is a groove starting at the "tear trough" at the inner corner of the eye and descending obliquely across the cheek. This can be either  a feature you are born with or something that develops with aging. Any of the hyaluronic acid injectable fillers (Restylane, Juvederm, Perlane) will give a nice result there, as would Radiesse. A more permanent solution would be fat grafting.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews

Fillers for tear trough

Fillers commonly are used to lift tear troughs. There may be different techniques that doctors use but I find that Restlane or Juvederm injected underneath the muscle causes less bruising and less chance of lumps.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Inject with Restylane for tear trough lines

It can do wonders if injected by an experienced injector.  From the picture you submitted I suspect that you will need 3 or 4 syringes however ( it can get expensive).   I don't see the grey/blue blebs described below when the filler is injected correctly into  the deep dermal area.

Vic Khanna, MD
Chicago Dermatologist
5.0 out of 5 stars 2 reviews

HA injections of the periorbita

Although a midface lift is an option for this area in general, I would not recommend it for you.  Too much surgery, not enough gain, and fillers are a much better option.  As you can see from other comments, you can use either restylane or juvederm (hyaluronic acids or HA's)  for a 6-12 month solution.  The two are very close, but have enough differences that I would suggest restylane here. 

First, juvederm does swell more when used around the eyes, so you can avoid that issue.  Two, the correct depth of injection is very deep, so if your doc knows what they are doing you have very little risk of lumpiness described by other commentators.  And three, both restylane and juvederm have now been shown to induce some collagen replacement with your own tissue as they resorb, so longer term effects are subtle but additive.  Plus, they are reversible if you don't like their result. 

The current formulation now comes premixed with lidocaine from the manufacturer, so it is a bit more comfortable than before.  A smaller caliber needle than what comes in the product is also available and makes the risk of bruising, and discomfort, less. 

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews

Both Restylane and Juvederm can work there

You can inject both Restylane or Juvederm in your cheeks.  They are both very safe when injected by someone with experience.  There are some differences in both of them.  Restylane has been approved for 6 month duration and juvederm for 9 months.  I think they are about the same in terms of length of duration in my experience ranging from 6 months to a year.  One thing to realize is the Restylane comes in 1.1 milliliters or cc's and Juvederm comes in about 0.8-0.9 ml or cc's.  You get a little more restylane than juvederm.  Some people think that Juvederm is smoother and results in less lumps but I think that hasn't been the case for me.  The great thing about Juvederm, Restylane, Perlane is that you can mold these products a bit and if after 2 weeks you have some augmentation that you don't like you can always inject some enzymes into the areas to decrease the amount of augmentation to get the very best results.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Restylane or juvederm for tear trough

The tear trough are is a tough area to treat.  I prefer restylane mixed with a local anesthetic to soften the injection process, to allow ease of molding , and to minimize bruising.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Restylane / Juvederm both good for Tear Trough but Sculptra is the best

The descent of the cheek soft tissues with age really exacerbates the tear trough. You can get instantaneous improvement with either Restylane or Juvederm. However to really build up the cheek you can use Sculptra which lasts 2 to 3 years.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 105 reviews

Tear Trough Deformity

A filler such as Restylane or Juvederm can fill that area and give you a result that may last a year or a bit longer.

I would recommend you seek out a board certified plastic surgeon to help you achieve what you are seeking.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 78 reviews

Be careful - filler injections under the eye can create visible grey lumps

While many physicians inject Juvederm, Restylane and other fillers beneth the lower eyelid to plump depressions that cause dark circles under the eye, I do not.

I do not because I have seen many patients who come to me after filler injections in this region with visible grey lumps caused by the filler showing through the thin eyelid skin. Other patients have had irregular lumps that protrude and are visible.

Some have had injections of hyaluronidase to dissolve the filler and then have irregular depressions.

In my view the proper techn ique for correcting depressions beneath the lower eyelid, often called dark circles under the eyes, is a surgical procedure called an open composite fat graft. I have done this procedure for mmany years and have done over 2500 laser eyelid cases and have had very satisfacory results.

You can see photos of results in my photo section labelled arcus release and fat grafting.

Also see the web reference below.

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.