Is Bellafill good for under eye zone? (Photo)

Question

I've heard a lot of doctors don't want to do Bellafill under eyes. I think it's because they want you to keep coming back for more temporary fillers. Anyone had good experience with Bellafill under eyes?

Edgardo Zavala, MD · Answer

The use of Bellafil, a permanent filler, if done properly achieves great results. It has to be performed with a cannula, not a needle, deep to the orbicularis  muscle and in the right amount usually blending the cheeks into the lower eyelids. I have performed many cases over the last 10 years and have never seen any complication. If done poorly the results are disastrous and that is why it is not advocated by many surgeons. Ask to see before and after pictures from your chosen doctor to see the type of results he or she gets. Good luck

Philip Solomon, MD, FRCS · Answer

Treating the under eye area will Bellafill is a common procedure in my practice.  A highly experienced injector is required, in order to achieve good results.  I inject in small quantities and directly on the bone.  If injected too superficially, permanent lumps may result.  In the 5+ years that I have been injecting Bellafill in this treatment area, I have not had any complications and the patients have been happy with the outcome.Hope this helps.Dr. Philip Solomon, Solomon Facial Plastic, Toronto, Canada

Nelson Castillo, MD · Answer

Thank you for sharing your question.  In small amounts Bellafill can be used in the lower eye but because the risks could involve 5 years worth of a mistake you will not find many injectors willing to place it.  Hyaluronic acid fillers last a long time in the undereye area and are much safer, having a dissolving agent if placement is inappropriate.  Hope this helps.

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. However, a combination approach will give the most improvement. Fillers (Belotero, Volbella, Restylane Silk), lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Michael I. Echavez, MD · Answer

I do not recommend the use of Bellafill under the eyes because it is possible to develop visible bumps or irregularities in this area with very thin skin.  Because Bellafill gives a long term result, any problems that develop can also be long term.  I find it is safer to use hyaluronic acid fillers under the eyes and frequently, these products last longer when injected under the eyes compared with other facial areas.

Richard E. Moore, MD · Answer

Thank you for your question. I do not place Bellafill in the tear troughs. My logic is simple. If you develop a complication you have a permanent product that is difficult to dissolve. These problems sometimes do not appear for years after the injection. I prefer to use PRP under the eyes as this will stimulate collagen to thicken and tighten the skin. I typically perform this procedure 3 times spaced apart by 4-6 weeks. A newer alternative, in the hands of an expert, is ALMI which is a combination of your PRP and minaturized lipocytes (fat cells) rich in regenerative cells. These involves a 10 minute fat harvesting procedure to draw up a syringe of your fat cells which then are passed through the miconizing process and added to PRP. This can then be injected like a dermal filler. I hope this was helpful - Dr. Moore

Faraz Valaie, MD · Answer

Hi Lisa,
Thanks for the question. To me safety is first and Bellafill is not the safest for tear trough area!
Sorry if this is not the answer that you were looking for!

Gerald Pierone Jr., MD · Answer

Hello and thanks for posting.
I don’t think many practitioners avoid Bellafill in the under eye region because they want to maximize profits, rather they are concerned about potential complications if it does not go well. Let me clearly state that the under eye region should only be injected by advanced injectors and this includes injections with reversible HA fillers. The skin is very thin in this region and any contour irregularities will be immediately apparent.  
  
I have seen excellent results with Bellafill in the under eye region, but in a small percentage of patients have also seen complications that are a challenge to correct. I think the key to using Bellafill in this location is to ensure that the product is placed under the orbicularis oculi muscle directly on periosteum and in small amounts.  For many patients, this approach will not fully correct the volume loss and then an HA filler (Restylane for example) or PDO threads can be layered into the areas of superficial volume loss. 
  
I hope that this information helps and best of luck to you!

Suneel Chilukuri, MD · Answer

Bellafill is a semi-permanent filler that was previously named Artefill.  It is not a safe product to place in the true tear trough (under eye) area.  The orbicularis oculi muscle is a circular muscle that causes the Bellafill to lump or create nodules.  Sometimes these nodules occur immediately while other times the nodules occur 2-10 years later.  Restylane, a hyaluronic acid (HA) filler, has been the safest product used to correct the true tear trough.  Juvederm Ultra And Ultra Plus in this area often cause delayed festooning (bags) when injected in this area. See an expert cosmetic dermatologist or plastic who routinely injects this area.  He or she will examine the entire orbit to see if you need support along the lateral orbit and / superior orbit.  The anatomy here is complex and the side effects can be devastating. Best of luck,Suneel Chilukuri, M.D.Houston, Texas

Barbara Schell, MD · Answer

I only use two fillers for the under eye area, and have excellent results with both. Bellafill is excellent under the eyes, but it must be used by a doctor who is very experienced in using Bellafill. It provides beautiful long lasting results and because it builds collagen as well, it helps reduce the lines as well. 
Most doctors do not have the experience to properly use Bellafill, especially under the eyes. They are also afraid of its longevity.  With a hyaluronic acid filler, ie. Juvederm, Restylane, Belotero, if a problem occurs it can be easily reversed.   The use of Bellafill and all fillers on the market today are not approved for use under the eyes, but are all used off-label.

Is Bellafill good for under eye zone? (Photo)

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