Which filler and quantity for volume and tear troughs? I have been told juvederm, beletero, and voluma.

I'm close to 40 and recently lost weight worsening my under the eye issues. I use botox, both cosmetically and for migraines for about two years and initially it did help with the under the eye issues but no longer does much. I also have to add I spend a lot of time outside, and I know that isn't helping the aging process:). I also have an autoimmune disease so safety is a concern. This would be my first filler and I would like to know the most effective and cost prohibitive route. Thank you.

Doctor Answers 2


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This is a common question.  I would definitely not use Juvederm in the tear trough area for a variety of reasons.  Voluma is so new I have no experience with it in the tear trough but I would be hesitant-it was not used there in any of the clinical trials.  Belotero would be a great choice if not much lifting is required or Restylane if more volume is required.  This can only be adequately assessed in person.  Good Luck.

Seattle Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Tear Troughs - Picking a filler

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Restylane has the most wide-spread usage so that could be a first consideration. Voluma is for mid face volume and is placed deeply to augment cheek area and chin. It's not designed for under the eye so wouldn't be your best option.

Depending on the autoimmune issues you have, filler may or may not be something that is against your primary physician's recommendation. Ask there first.

Everyone has different metabolic rates so the actual longevity of filler under the eye can't be something any doctor can set in stone for you. Still, any filler you place under the eye should be something that could be dissolved and the only products with that potential are the hyaluronic gels.

IF your primary physician does not see your condition as one that would dictate you not risk fillers, then my recommendation is to seek out a board certified physician (dermatologist or plastic / oculoplastic surgeon) with a lot of under eye injection experience.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

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