Use of Artefill / Bellafill under the eyes?

I would not recommend using Bellafill (formerly Artefill) under the eyes.  My preference is to only use one of the hyaluronic acid fillers (such as Restylane) under the eyes.  Because the skin of the under eye are is so thin, sometimes a visible irregularity can develop when filling the area and I find the hyaluronic acid fillers to be the least likely to cause any issue.  Hyaluronic acid fillers can also be dissolved, if needed, unlike the other fillers.  

Bellafill is a long lasting filler that is great in many areas of the face.  It can be used in tear troughs and around the eyes but you have to go to someone who uses fillers in high volume and uses Bellafill in that area.  Best thing is to be conservative and do a little at a time in this area.  HAs are still preferred in most patients however sooo many patients have issues with chronic swelling or lumpiness around the eye area and have turned to bellafill as an option.  Fillers around the eyes should not be injected with a needle because of the risk of blindness and cannulas are preferred for injection. 

Thank you for the great question. I do NOT recommend placement of Bellafill in this area. I use exclusively hyaluronic acid (HA) products in this area -- mostly Restylane and Belotero. If you are looking for a longer-lasting alternative for the tear troughs, I would recommend structural fat grafting. This is a minor surgery with a short recovery. Bellafill is fantastic for areas of the face with thicker skin -- the cheeks and nasolabial folds -- and even along the jawline.

This is a technically difficult area to inject.  I would suggest a "dilute" BellaFill (mixed 1:1 with lidocaine) placed just on top of the orbital rim.  Inject no more than 0.5cc of dilute BellaFill for each eyelid and then touch up if more volume wanted.  Be very careful to only use an injector experienced with BellaFill.

I use fat, Bellafill and hyaluronic acids under the eye.  Although the HA do attract water and have the possibility of a Tindall Effect that has not been a major problem for me.  This may be because I place my filler very deep, just over the bone, which gives a very natural result.  It is a great choice for a patient who wants to "try out" the filler.  Fat is great because it is permenant but a little more involved to get with a little more down time.  Bellafill has been a great office option for my patints as well.

Our office is a regional referral center for filler complications and we continue to see longterm complications from fillers, including Artefill and Bellafill. We do not recommend the filler around the eyes. Best, Dr. Karamanoukian Los Angeles