Filler Myth for Under Eye Hollows?

I'm a 27 year old woman and I'm considering getting Restylane for my under eye hollows. I can see the veins and the blue skin underneath. A friend of mine warned me that it's too early for me to start now and that each time I get Restylane, that the injections will create a "pocket" of sorts which will make the hollowing even worse over time as injections cause tissue to expand (??) Is this really true? I've never heard of filler doing this. And if true, can you recommend an alternative? Thanks!

Doctor Answers 12

Worsening hollows under eyes with filler

I have not seen a situation, or heard of one for that matter, in which worsening hollows under the eyes are unequivocally linked to the injection of Restylane, or any filler.  In general we intend only to fill in areas of deficient volume, and we don't expect to see "stretching" of the tissues when we do this.  In fact, a number of studies have shown actual thickening of tissues and collagen production resulting from filler injection.

San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Myth of injectable treatments (Restylane filler or Botox) making things worse over time: it's a myth!

The biggest worry that patients have other than side effects, is whether starting anti-aging treatments will make them age faster over time. This is an absolute myth and does not happen. Botox and Dysport weaken the communication between nerve and muscle, so the muscle weakens, but if you let them wear off and give your muscles time to get back into the swing of things, function fully returns to normal over time, and you'll eventually get all of those wrinkles back (in case you missed them!). If you do Botox or Dysport regularly for many years, you may be ahead of the game and never get all of your wrinkles back, but you will get all of your normal muscle function back.

With the fillers, treatment over time actually can improve your tissue elasticity and collagen quality, rather than, as you describe that your friend scared you with, creating hollow pockets that will cause increased sagging and hollowness over time.

Do not fear treatments, if done by a properly trained, experienced BOARD-CERTIFIED cosmetic physician from one of the four CORE cosmetic specialties. These include dermatology/derm surgery, plastic surgery, ENT/facial plastic surgery, and oculoplastic surgery. Think three times about getting treatment from someone else.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Restylane is great option to treat undereye hollows

"You're too young for _x_" is often said by friends that mean well, but in reality whether or not you would benefit from filler is not based on your age. It's based on what condition you have and whether or not the treatment will improve that condition. If you have hollow undereye region, then filler is an excellent option. I prefer Restylane in this area, and caution you to go to only a physician with experience treating this area. There are risks involved, and meticulous technique is key to getting a good result. Filler for undereye hollows (or "tear troughs") is injected right along the bone. I have never heard of fillers creating pockets or making hollowing worse. It sounds like those were comments that arose from fear. Also, rather than needing more filler over time, I have noticed the exact opposite. Patients actually tend to need less filler over time, since the fillers stimulate your own collagen.

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Tear trough restylane

I perform this frequently. The results can be outstanding but it can take a little longer than nasolabials or lips to settle. It shouldn't create a pocket as these are dermal fillers (ie.... they are filling skin!) .... restylane is basically like injecting a liquid sponge that holds water for 9 months or so.

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
4.9 out of 5 stars 172 reviews

Restylane for Under Eye Hollows ("Tear Troughs")

Thank you for the great question. Restylane is a great option for the under eye hollows, even in younger patients (late 20's to 30's). The filling effect generally lasts 6 to 9 months. Though injecting in this area does require good hands, there are no long-term effects like stretching or pocket-formation that I have seen in my practice. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 113 reviews

Filler Myth for Under Eye Hollows?

     The under eye hollows or tear troughs can be treated with Restylane, and this should not result in future negative repercussions with regard to creating hollows.  Kenneth Hughes, MD Los Angeles, CA 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Restylane will not worsen under eyes over ti

Well done tear trough filling will not cause premature aging of the under eye area. Results are often amazing

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 209 reviews

Filler Myth for Under Eye Hollows?

Undereye filler treatments will camouflage the current hollowing of the undereye or bulging of undereye bags. They will not create worsening of this condition and should not stretch the surrounding tissue. This is a more challenging area to treat so seek a highly experienced injector who commonly treats the undereye area. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Fillers for under eye hollows

It's good you are asking for advice and not just trusting your friend. Many people misstate things all the time, and your friend certainly is. Fillers when done properly simply fill in areas with hollows or lines or wrinkles. It's when you begin filling areas or overfilling areas that don't really need it, and over very long periods of time, that you can slightly (SLIGHTLY!) stretch tissue (again, this is so minimal I don't even think it's worth being worried about). It doesn't happen when you have actual hollows that you are trying to fill in.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Not true.

There is always someone around who thinks they know everything.  The under eye filler service is one of the greatest innovations in cosmetic surgery in the past 20 years.  Don't let your well meaning but ignorant friend talk you out of this service.  What is true is that the treatment can be fussy.  It really needs to be performed by an expert.  Take your time, do your research to find the right injector.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.