How many syringes of Restylane is needed for under eye bags? (photo)

There are several things you need to understand about these services.First-under eye circle treatment with hyaluronic acid filer is the state of the art treatment for this area. It is far better than surgery, and much more predicatable than fat grafting.  Second-As great a treatment as this is, it is a fussy treatment.  You are asking a physician to sculpt you with the hyaluronic acid fillers.  Unfortunately they do not teach sculpting in medical school.  Rare doctors are very good at this.  Many doctors lack the skills and talent to pull these treatments off.  Even in the best of hands, about 30% of these treatments need to be adjusted to have the product sit correctly in the lower eyelid and not look like a treatment.Third- To accurately estimate volume, a physical exam of the bony orbital rim is essential.  The shape of the bony orbital rim varies.  In some it is right there and it actually makes what looks like a bump or a bag in the eyelid.  That is favorable for filling because the bone acts like a backstop.  In others, the bony rim rolls off into the orbit.  Rims shaped that way require much more product because the bone does not act like a backstop.  I estimate that you need about 3 ml of hyaluronic acid filler for this.Fourth-Which hyaluronic acid filler is critical.  There are many brands and filler products.  It makes some physicians head spin.  It is not that all these products are really needed.  The manufactures are cynically involved in channel stuffing to maximize their profits.  Doctors often do not really understand how these products work and simply take the manufactures sales reps at their word.  What product is used is critical to get a good result.  I only use Restylane in the lower eyelid.  The so-called smooth fillers are runny.  They do not stay where they are put.  They are designed this way because manufactures understand that many injectors are not good at placing products and the smooth fillers reduce the likelihood of lumps and bumps.  While that sounds good, it also means that fillers will end up in the wrong place.  I prefer fussy fillers that put a premium on sculpting and stay where placed. This avoids the risk of post-procedure ridges which can be seen when using products like Juvederm, Belotero, and Restylane Silk when treating the under eye circles.

I my experience doing this over many years it has been one syringe only.  The key is injection technique and placement to give you amazing results without any bumps nor bruising whatsoever.  Thanks

Hi @MissZee310! I would recommend starting with 1 syringe and re-evaluating after two weeks. The tear trough area is a very delicate area and overfilling the area is not recommended. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Typically one tube of Retylane is sufficient to treat under eye wrinkles.  It is always better to start with a conservative treatment as more can be added if necessary.  I would make an appointment with a doctor who has experience in this area so that you can be examined and determine the treatment that is right for you.  Good luck!

Thank you for your questions. The use of dermal fillers under the eye area is great to soften the appearance of bags as well as dark circles. In order to determine how many syringes of dermal filler needed to correct the concern, it would be best to have an in person consultation with a provider that specializes in this type of procedure. The area under the eye is very delicate and needs to be handled with care and precision. Most patients need about 1-2 syringes of dermal filler to achieve the desired result, but this could vary per individual. 

Thank you for sharing your question and photo. You are an excellent candidate for filler to restore lost volume to the under eyes. Based on your photo, I would recommend 2 syringes of a hyaluronic acid filler, such as Restylane, for your first treatment. I prefer Restylane in this area because it draws less water than other products, which in turn minimizes swelling. I also like to use the microcannula technique when treating the under eyes, which minimizes the risk of swelling and bruising commonly associated with injections in this area. For more information about under eye treatments, I recommend scheduling a consultation with a board-certified specialist who is experienced with the microcannula technique. 

 Thank you for sharing your question. Restylane is a great tool for hiding mild to moderate eyelid bags. From the looks of your photograph, you probably require one syringe. Make an appointment for consultation with an Oculoplastic Surgeon for detailed evaluation and discussion of appropriate treatment. Good luck, 

More is not necessarily better. Filler injection can certainly help with your under eye hollowness relative to the bags but you should not expect to have perfectly smooth under eye area because that would require too much filler which would show through the skin. 1 syringe or perhaps max of 2 syringes. Alternatively, you can do transconjunctival lower blepharoplasty with fat/bags repositioning to fill the hollow area while also getting rid of the bags. See following link and video.

The amount of filler needed will vary, but a combination approach will is needed to get the most improvement. Fillers, 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

Dear MissZee310,
I would advise you to consult with a board-certified plastic surgeon. Normally, tear troughs are corrected using one syringe of Restylane.
Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery