Restylane or Restylane plus Voluma for under eyes? (Photo)

I had a consultation for my under eye 'bags' (seeking a short & long term fix). Based on my previous research I was expecting to the Dr. to confirm Restylane was needed short term. He recommended .5cc of Restylane plus .5cc of Voluma (on upper cheeks) for a smooth transition from the under eye to upper check area. I went back and tried to research how Voluma could impact the 'shadowing' of the under eye but I haven't found much. Any thoughts on the best injections would be great. Thank You!

Doctor Answers 12

Filler for under eye 'bags'

As the saying goes 'there are many ways to skin a cat' - kind of gross in this context but means that your physician can accomplish the same result in different ways and with different fillers. 

Because use of filler for tear troughs (the hollow between the fat pad under the eye and the fat pad of the lower cheek that causes the eyes to look like they have bags or dark circles) is 'off label' you won't find anything about it on any of the pharma companies sites.  However I and other top injectors include it in our lectures at meetings around the global be.  Five years ago the thought was to fill the tear trough directly. However, some patients looked puffy. Now the standard of care is to start from the side and work our way in. By lifting the skin below and to the side, we lift the hollow. This can be accomplished with voluma, restylane or Perlane/restylane lift.  If more superficial filling is needed we use belotero. 

Your photo is also limited to your eyes. If your face overall is starting to be depleted or you are naturally very thin, Sculptra may be the best option used in the temples, cheeks, jawline etc.

Another question is why you need two different fillers? Does that increase your price? A 1 cc syringe of one filler is generally most cost effective unless your physician is splitting up syringes in a sterile manner.

This is all to say there is no one way...

I hope this answer was helpful.
Best wishes!


New York Dermatologist
5.0 out of 5 stars 9 reviews

Under eye fillers

Under eye tear troughs can be treated with hyaluronic fillers. I prefer to use restylane and dilute is so that it flows easily.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Bags under eyes

From the photos it appears you do not have bags, but circles and increased pigment. also from the appearance of your cheeks i dont think you would really need Voluma. Restylane would help the indentation under the eyes

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Restylane and Voluma for under eyes

Thank you for your question.  I would explain your injector's recommendation as follows:
1)  Restylane can be used to directly soften shadows under the eye by filling in the tear trough depression
2)  Voluma can indirectly soften the shadows by subtly recruiting some of the laxity under the eyes in an outward and upward direction using advanced injection techniques.
Using both the direct and indirect approach usually provides an even softer look and transition.  Hope this helps. 

Which Filler for under they eye concerns?

Dear amaceb2008:

Thanks for sharing your photos. They do help but are not optimal so my reply depends on the findings at a in-person consultation.

Pigmentation or dark circles under the eyelid may come from any combination of the following.

1. Eyelid bags and laxity with shadowing
2. Cheek laxity and shadowing
3. Thin eyelid skin with a reflection of the underlying muscle
4. A separation of the eyelid structures from the sagging cheek structures
5. Pigmentation, laxity and fine lines of the skin

Many options are available depending on the problem above and how long you wish the problem resolved.

1. Eyelid lift
2. Cheek lift 
3. Injection of fillers, either into the skin or deep under the fat for volumizing using Restylane, Juvederm or fat
Injectables like any other procedure takes experience, talent and skill. Today, there are many techniques to achieve the improvements you desire depending on which problem exists: bone, deep fat, separation of tissues, superficial fat, skin creases. 4. Mid-face lift, a lift of all the structures of the cheek with a eyelid lift
5. ZO Obagi Skin therapeutics and Peel or Laser to rejuvenate and tighten eyelid and facial skin.

You are best served with a well experienced, Board Certified Plastic Surgeon or ENT Face surgeon who understands the anatomy, the nuances of the different fillers and has the skills to achieve what you want. 

I wish you the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 70 reviews

Under eye bags and dark circles may be improved with one filler

As other cosmetic specialists have stated, there isn't one particular best method to treat under eye bags and dark circles without surgery. This area is sensitive, so most plastic surgeons and dermatologist will suggest starting with one filler, then add more as needed on a separate visit.

Best,
Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 79 reviews

I probably would use Juvaderm or Restylane for your tear trough

it is hard to be sure based on your photos but it does not appear that you would 
benefit from Voluma for your infraorbital rim. i really like Voluma for augmenting 
the infraorbital rim and that will often help with the tear troughs but it has to be 
in the correct clinical setting.

david berman md

David E. Berman, MD
Sterling Plastic Surgeon
4.9 out of 5 stars 82 reviews

Restylane or Restylane plus Voluma for under eyes? (Photo)

I agree with the others drs answering. It doesn't look like the kind of indentation that fillers improve. Voluma is very difficult to remove, so using it doesn't offer any improvement over restylane, which I have seen last 2-4 years under the eyes.  

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 8 reviews

Dark circles under the eyes: what to do?

The area you seek to treat appears to be the result of vascularity and/or pigmentation of the tissue of the lower eyelid. So in one sense, this is not likely to improve with injections. On the other hand, we do often see some improvement with the careful use of filler in cases like yours. This is because the mild amount of additional volume can allow that area to capture a little more light, and appear brighter and more youthful as a result. I hope this helps!

Patrick J. Byrne, MD, FACS
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Under Eye Bags

Although the photos provide a limited ability to make an evaluation, what you may be describing as "bags" under your eyes appears to be pigmentation.  There is no filler that will change this.  On the other hand, volume addition to your cheeks with something like Voluma would provide aesthetic benefit

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 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.