Is it possible to improve my protruding eyes with filler? (Photo)

Question

Hi, I have slightly protruding eyes, I wanted to know if it is possible to improve the situation with filler in the brow ridge and under the eyes to avoid invasive interventions. Especially when I smile as you can see in the third photo I get all those wrinkles. I think I have them genetically, I just want to understand if it's due to a lack of bone support or if the eyeballs are just further forward And I wanted to know if the filler could cause blindness

Anna Chacon, MD, FAAD · Answer

Improving the appearance of protruding eyes with dermal fillers is a nuanced process and depends on individual anatomy. Here are some considerations:

Understanding Protruding Eyes: Protruding eyes can be due to several factors, including genetics, bone structure, or the positioning of the eyeballs. A lack of bone support in the brow ridge or under-eye area might contribute to this appearance.

Use of Fillers: Dermal fillers can potentially enhance the area around the eyes by adding volume to the brow ridge and under-eye area, which may help create a more balanced appearance. Fillers are often used to smooth wrinkles and hollows, which can also contribute to a more harmonious look when smiling.

Addressing Wrinkles: Fillers can help reduce the appearance of wrinkles by adding volume and support to the skin. However, for dynamic wrinkles (those that appear with facial expressions), neuromodulators like Botox might be more effective.

Safety Concerns: While dermal fillers are generally safe when administered by a qualified and experienced professional, there are risks associated with any cosmetic procedure. One rare but serious risk is blindness, which can occur if filler is inadvertently injected into a blood vessel that supplies the eye. This highlights the importance of choosing a skilled and experienced injector.

Consultation: It's crucial to consult with a board-certified dermatologist or plastic surgeon who specializes in facial aesthetics. They can assess your specific concerns, evaluate your facial structure, and recommend the best course of action.

Ultimately, a professional evaluation will help determine whether fillers can achieve your desired results and ensure the procedure is performed safely.

Nelson Lee Novick, MD · Answer

At least from the photos provided, the two major issues here are under-eye hollows and accentuation of the under-eye "jelly rolls" when smiling. If this is indeed so, then the use of an appropriate HA volumizing filler and Botox would be in order.
Since the upper cheeks are the major support for the undereyes, when there is volume deficit in the the cheeks, the under-eyes would hollow out. Accordingly, the appropriate choice of an HA volumizing filler properly injected in the region of the upper cheek-infraorbital border would smooth the transition between these two regions and significantly diminish the appearance of "bulging" eyes. 
As to the "jelly rolls" that form when smiling, these are simply an over exaggerated contraction of the under-eye muscles and can be diminished with a few microdroplets of Botox.
While filler has been reported to cause blindness, this is quite rare and is generally associated with injection by inexperienced injectors and/or an inappropriate choice filler. 
You would be wise to seek consultation with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

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