Use of Artefill / Bellafill under the eyes?

Question

I'm wondering about the current line of thinking about the use of Bellafill under the eyes for dark circles. I see some doctors here not recommending it be used there, although some of those remarks are a couple years old.

Michael I. Echavez, MD · Answer

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.

Mike Majmundar, MD · Answer

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.

Evan Ransom, MD, FACS · Answer

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.

John L. Burns Jr., MD · Answer

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.

Hannah Vargas, MD · Answer

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.

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

I suggest avoiding any permanent fillers in large quantities under the eyes unless they are done by a very meticulous surgeon using cannulas for injections. I use radiesse and fat in those areas and have good experience with Belafill as well, but it all depends on the individual person and their long term goals.  I suggest going to a facial contouring specialist for treatment.  Best, Dr. Emer.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  I do not recommend Bellafill in the tear troughs, or under the eyes.  It is too difficult to correct if it is not done perfectly, and it is not always forgiving in the long run.  There are other options for the tear troughs if you really feel that is something that would be worth the risk for you.  Please make sure you are seeing a very experienced board certified dermatologist or plastic surgeon who will be there for you if anything does not turn out the way you want it to after such a delicate procedure.
Best of luck!

Barry Ginsburg, MD · Answer

I dont inject bellafill in the tear trough. I think we need to be very precise under the eyes as even a mm or 2 will make a difference.. also I have seen many reports of of swelling under the eyes with HA fillers and I dont want to risk putting something permanent there

Flora Levin, MD, FACS · Answer

I do not recommend Bellafill in the eye area. The skin there is very thin and not forgiving - any irregularity or imperfection will be more visible than elsewhere on the face and the filler cannot be dissolved. It is a great choice for many other parts of the face, but not around the eyes.

Use of Artefill / Bellafill under the eyes?

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