Which filler would you recommend and which is more effective between Botox, Dysport, and Xeomin?

hello, right now in my life for being 43 years old i feel great and i think i look pretty good . but of course we all have things we"d like to change. the thing that bothers me most is the tear trough area, and the upper eyelid. i know in the near furure i will be getting an upper and lower eyelid lift, along with a face/neck lift. until then can i get a filler that will last in the tear trough area, and botox/dysport in the upper eyelid area to lift a little.is this possible without surgery?

Doctor Answers 9

Fillers and Botox

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All are great choices and effective.Botox and Dysport have been on the market much longer than Xeomin.For the tear troughs, the best fillers are Belotero and Restylane. They are soft and have the least risk of causing unwanted bumps and swelling.

Santa Monica Dermatologic Surgeon
3.9 out of 5 stars 9 reviews

Options for nonsurgical periorbital rejuvenation

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For the tear troughs and periorbital area Belotero and Restylane are excellent options.  The skin under the eyes is thin, and contour irregularities and lumps can be easily visible.  Belotero is the softest of the hyaluronic acid fillers, and as with all the HA fillers has the advantage of being reversible.  

Botox and Dysport have similar properties and durations of activity.  Multiple studies have tried to discern the differences, but ultimately your result will depend more on the skill of your physician than the type of neuromodulator that is used.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 63 reviews

Fillers and neuromodulator

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There are many good options for fillers to augment different areas of the face. The neuromodulators available including botox, xeomin, or disport are all good.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Which filler would you recommend and which is more effective between Botox, Dysport, and Xeomin?

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Yes, dermal fillers can help while waiting for a face and neck lift.  Neuromodulators (Botox, Xeomin or Dysport) can be used to give a slight lift to the eybrows reducing the upper eyelid fullness.  I often shape the cheeks with dermal fillers (I prefer Perlane) that will add a more youthful and naturally attractive loof to the face.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Fillers Restore Youth

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Thank you for your question. Yes, fillers do an amazing job to lift and restore youth, but without seeing your photo it is hard to give accurate information. At my practice, facial rejuvenation is very popular and can be performed within minutes to give patients immediate results! After a thorough consultation with each patient, I select and choose a specific filler for each patient depending on their unique facial characteristics and bone structure. Generally, I use a combination of fillers such as Voluma and Juvederm to lift the jowls, which also corrects and fills the hollowness. I also use Botox to help smooth and improve the upper eyelids, forehead lines, and brows.

Ariel Ostad, MD
New York Dermatologic Surgeon
4.3 out of 5 stars 17 reviews

FIllers and Botox are great for nonsurgical eye rejuvination

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A combination of filler and a Botox substance are a great option to rejuvenate the appearance of the eyes.  Fillers like Boletero, are good at filling in the tear trough wrinkle under the eye.  Juvederm can also be used, but because it attracts water, it can cause some unwanted swelling after it is injected.  Botox, Dysport, and Xiomin are all equally effective in treating the crows feet wrinkles and can also be used to create a lift of the lateral eyebrow. 

Which Filler and Muscle relaxer?

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Dear tonyarl72:

Every patient is unique. Your bony and soft tissues, their symmetry and aging, your personal and perceived appearance and how it bothers you are just a few of the factors to review with a well experienced, Board Certified Plastic Surgeon or Facial ENT Surgeon who offers ALL these and other options.

Since the effects of aging, weathering, sun-damage, ethnic background affects everyone differently, you may consider filler for the tear trough and Botox for the brow elevation and / or stage your surgery at this time when healing is better, scars will usually be smaller and skin elasticity is at its best. 

Consider more than one well experienced, Board Certified surgeons for evaluation as you may find that their Botox and Filler skills as well as their surgical skills and results will vary.

One consideration come to mind and that is you may wish to have the upper and lower lids improved at the same time. Using access gained by both incisions, a mid-face lift may rejuvenate your cheeks, eliminate the tear trough, possibly elevate your jowls and bring you a longer duration of satisfaction.

If you are a candidate for a short scar face lift (or MACS lift and other named procedures) you may improve the jowling and upper neck while younger and gain more youthful appearing years. 

Regarding which Fillers or Muscle Relaxers; the options are getting so numerous that each filler or muscle relaxers have their own peculiar niche of use.

I happen to like Botox in the brow area for precision and Dysport in the lips for a softer relaxation. 

Hyaluronic Gel fillers such as the Restylane Family or Juvederm Family each have their nuances. Depending on each gels production and artificial molecular linking will determine:
  1. their duration,
  2. their projection, 
  3. their volumization (ie. water attraction).
This determines where they provide the best "fill" you desire.

Noting your tear trough example, some injectors have only superficial injector skills and will inject immediately under or within the skin (ie. dermis). Others, may feel comfortable injecting under the deeper muscles of the cheek next to the bone with a variety of techniques.
  1. You may wish to use Restylane or Juvederm superficially but it has the side-effect of radiating a "tindel" bluish coloration or lumpiness on eyelid skin.
  2. Silk in this location superficially may swell the tissues too much.
  3. I achieve my best appearance under and over the deep muscles of the cheek with a more linked, longer duration filler such as Voluma or Perlane.
Yes, the possibilities are endless today and so you must find and trust a surgeon with a lot of experience using each option selected for your anatomy, concerns and budget.

I hope this has been helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 100 reviews


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Hi.  Fillers can work quite nicely for the tear trough area.  I prefer Belotero and the newer Restylane Silk for this area.  If your eyebrow position is slightly low, then Botox can give you a slight lift in that area.

All the best,

Non-surgical options for rejuvenation of the area around the eye

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There are many nonsurgical options for treating all of your concerns. In fact, many people are delaying surgery as long as possible and fillers and toxins help make this possible. A consultation with a board-certified specialist would be helpful to determine what treatments you might be a candidate for. As far as Botox, Dysport and Xeomin goes - all three work well for these areas. Good Luck! 
Dr. Harmych

Brian Harmych, MD
Cleveland Facial Plastic Surgeon
5.0 out of 5 stars 13 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.