Will Under Eye Restylane Injection Be Noticeable when Smiling?

Question

I am considering having Restylane in the hollows under my eyes.  Will the filler be noticeable when I smile or give me a frozen look?

Jeffrey E. Schreiber, MD, FACS · Answer

Hello - Yes, Restylane is great for treating the hollowness under the eyes, and shouldn't give you the frozen look that Botox can do. However, if you get Restylane placed into lines that are only present when you smile, then you may be able to see them at rest. Lines that are present in repose are the ones that should be treated with Restylane.

Rebecca Fitzgerald, MD · Answer

Under eye use of Restylane is becoming more and more popular because it can work so well to reduce an overly depressed under eye "hollow".
Depth of injection is critical. Balance is critical. The physician has to take into account much more than just the hollow area under the eye. The perfect correction will not be noticeable at all and will not show at all when you are smiling or at rest.
Thoroughly vet your injecting physician. There is an art to doing this particular injection correctly and and not every physician has the eye to do it well. Ask to see photos of patients your doctor has treated. This will be one of the best ways to make sure you will get what you are looking for.
Be sure to follow pre-injection directions as certain supplements or medications will make you more susceptible to bruising and/or swelling. Do it a little at a time if your hollows are deep. Incremental depositing of the filler will prevent any over correction and allow you to get an even symmetrical result.

Ron Shelton, MD · Answer

Both Juvederm and Restylane are hyaluronic acids that can fill in hollows. It depends on exactly where the holow is. If it is close to the eyelashes of the lower eyelid, then the filler must be injected above the muscle and this may leave obvious bumps and because it is very difficult to make the filler look homogenous under this very very thin skin.  Also, bruising is very possible in this superficial plane.
The tear trough which is lower on the eyelid skin adjacent to the beginning of the top of the cheek, can be filled below the muscle and gives a more natural appearance. It won't freeze your face when you smile because you should not get such a large volume that it interferes with your smile or lumps up.  Fillers don't affect the muscle action as Botox does.
This treatment is considered an off-label use by the FDA. Make sure you see an experienced injector in consultation to review your concerns.

Joel Schlessinger, MD · Answer

If there is one thing that is done wrong repeatedly by newcomers and ill trained cosmetic surgeons, that would be restylane and/or other fillers under the eyes.  While it seems like it should be a slam dunk, it never is for some docs.
The results can be horrible and long lasting in the hands of a poorly trained cosmetic surgeon wannabe.  For this reason, make sure you go to someone who does hundreds or thousands of these a year and don't go for cheap.  Avoid medispas and places where the nurse is the injector.
Make sure you get a doctor who is willing to stand by their work and don't go to someone who has anything but a stellar reputation for doing this correctly. Good luck!

Scott Trimas, MD · Answer

Hyaluronic acid fillers like Restylane used in small aliquots is an excellent treatment for tear trough deformities or hollowness in the area between the lower eyelid rim and nose. However, too much in that area can create a swollen appearance as well as a bluish tinge to the skin so make sure your surgeon is experienced in injection techniques in that area and uses small amounts.

Kenneth D. Steinsapir, MD · Answer

Sandra
How you will do with under eye Restylane -- any treatment really-depends on your issues.  I recommend a consultation with a respected under eye injector in your area.  Be certain the doctor has a track record of treating the under eye areas.  Done properly the filler will help the lower eyelid wrinkles even when you smile.

David Shafer, MD, FACS · Answer

Restylane or Juvederm (both HA dermal fillers) are good for around the eyes. However, you need to make sure that you are being injected by an experienced injector. The skin around the eyes is very thin and too much product or too superficial of injections can lead to visible product.

Otto Joseph Placik, MD · Answer

The use of Restylane for eye hollows can provide excellent results. The product can be injected incrementally to create subtle changes. It should not create a frrozen look but should improve facial contours. The Restylane should not be visible when smiling.
Another advantage is the ability to correct or remove excess product wtih the off label use of hyaluronidase.

Robert L. Kraft, MD, FACS · Answer

Restylane will not give you a frozen look. Unlike Botox, it is a filler, not a neurotoxin or paralytic agent. By filling the ara under the eyes, it should create a more youthful appearance and will not be noticeable. It does not create the big puffed cheek effect of Radiesse. What it will do is to fill the hollows under your eyes to create an aesthetically pleasing look and take years off your face. The skin around the eyes is delicate which is why Restylane is superior to other, more globular filler materials. Definitely seek a board certified plastic surgeon who has a lot of experience with Restylane and can devote the appropriate time to a treatment session.

Nissan Pilest, MD · Answer

To correct the hallowness under the eye Hyaluronic acid based fillers such as Restylane, Juvederm or Prevelle all work well.
The most important issue however is that you must make sure your injector is experienced in injecting tear troughs and under eyes otherwise you will encounter lumps and bumps in that area

Will Under Eye Restylane Injection Be Noticeable when Smiling?

Answers (13)

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