More Juvederm or Retin A under eyes?

3 years ago I had Juvederm injections to tear troughs. Now that Juvederm is nearly gone I notice horizontal and vertical wrinkling under eyes. I started using Retin A under the eyes 4 weeks ago. Will the application of Retina A help or would more juvederm fill in these areas?

Doctor Answers 5


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I find restylane to be a great treatment for tear troughs as it doesn't swell as much. Sometimes we need to tighten the skin to get the best result, or move the fat from your eyelids into the tear trough.
Three years ago is a long time and what I also find is typical when treating that area.

Make sure you go somewhere where they do this often as tear troughs can be tricky and you don't want to overfill.

Best of luck!

Treatment of under eye area

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There are several non-surgical treatment approaches when it comes to under-eye area that include the following:
1. Botox injections to diminish the appearance of "wrinkling" - advanced technique so should be only done by expert injectors.
2. Fillers which are typically used to diminish "hollows"
3. Laser resurfacing including fractional ablative and non-ablative resurfacing
4. Non-laser tightening procedures including Ultherapy
5. Creams including retinoids - these are usually long-term options which take months to produce significant visible results. 

If those are not appropriate, you also have a surgical route which would be another consideration. 

Andrei Metelitsa, MD, FRCPC
Calgary Dermatologic Surgeon

Best choice for Undereye Wrinkles

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Both! RetinA is terrific for building collagen in this area of very thin skin.  It will enhance the texture and thickness of the skin and reduce fine lines and wrinkles. Juvederm is better for filling tear troughs in that area and gives an immediate effect. Don't forget that fractional CO2 lasers can also dramatically improve that area due to their ability to remodel the skin and turn on your body's natural collagen production.

Melissa Toyos, MD
Nashville Ophthalmologist

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Loose eyelid skin and wrinkles

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Dear Marie, 
Thank you for your question. Our lower eyelid area ages in three ways, loss of volume, loose skin and formation of dynamic wrinkles. Hence it is very important to address all three problems in order to maintain a harmonious result. All too often I see patients from other locations, whose practitioners placed filler in the lower lids, and because their skin was loose, they had to put in a lot of filler to get rid of the wrinkles (more than they would have needed to place  just to restore the volume loss). To cut a long story short (there are many other factors that play an important role here, in this very complicated anatomical area), it is important to be evaluated by a Board Certified Facial Plastic surgeon who has the pre-requisite anatomical knowledge for this area and who is very experienced in noninvasive rejuvenation, in order to choose the best treatment plan for you. Typically one would want to tighten the skin first with non-invasive radio frequency treatments e.g. ThermiSmooth or Fractora or Thermage etc etc before placing any filler. Also retina A around the eye can cause a lot of irritation and make the wrinkling look even worse often times so be careful ! I would suggest a product that has growth factors and tightening qualities in addition to the above mentioned treatments.

Best of Luck in your Quest !

Dr. Anna Petropoulos 
Boston's North Shore

Injections under the Eyes and Lasers

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If your eyes looked better and rejuvenated then  I would absolutely return for more fillers under the eyes such as Restylane, or Belotero.  You can also do eMatrix under the eyes as well as Fraxel to help the lines as well.  Best, Dr. Green

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