What fillers would recommended to fill in tear trough and create a lifted, more symmetrical look? 27 female (Photo)

Hi, I'm primarily considering belotero for my tear troughs. I was also considering filler in my cheek to create a more lifted, contoured appearance but I wasn't sure which one or how much I would need. What are my best injectable corrections? Going for them next month, your expert advice is immensely appreciated!

Doctor Answers 7

Tear Trough / Cheek Injections

Thanks so much for your question. As has been said, there are many options to treat both the tear trough area and to improve and enhance malar contour.

In your case, you have a tad bit of midface hollowing (which is normal in women in their late 20s-30s), which is likely accentuating the shadowing of your under eye area. You would look subtly more full and defined with likely 1-2 ccs of a product that lifts the malar region - Voluma or Restylane Lift. This product can also be placed along your cheekbone to help give you more definition. This, in addition to either restylane or belotero will help to smooth out your overall contour.

Although injections are relatively safe, there is always associated bruising and swelling which can last anywhere from 1-3 weeks under the eye. If you decide to have this procedure, be sure not to do it right around a major event.

Good luck!

Smithtown Plastic Surgeon
5.0 out of 5 stars 18 reviews

Belotero for under eye hollows

I would recommend Belotero for your under eye winkles and a more volumizing filler like Lyft or Voluma for the cheeks.  You are young so you don't want to have it overdone.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Belotero for under eye hollows

Belotero can be an excellent filler for under eye hollows. It is a very thin and smooth product which allows it to be safely placed more superficially or in areas of thinner skin. There are other options as well, such as Restylane which tends to be a popular choice for this area. For the cheeks, I would not recommend Belotero since it is not great for larger volumization and lifting. Other products such as Restylane Lift, Voluma, or Radiesse would be more appropriate in this location. The bottom line is that the most important factor is the injector, not what is being injected. Within reason, many products can be used to achieve identical effects as long as the injector is skilled and experienced. Best to find a good cosmetic dermatologist to help you with your concerns. Good luck!

Douglas Wu, MD
San Diego Dermatologist
4.9 out of 5 stars 46 reviews

Best Filler for Under Eyes is Fat

"If I have a hammer - the world is a nail!"
Many physicians are comfortable injecting Hyaluronic Acid fillers under the eyes and in the tear troughs. However, when reviewing the patient complaints on this website, many are complaining of the lumps and bumps that they see. The truth is that almost all HA fillers are too cohesive to get a smooth natural result under the eyes and for those that are happy, the volume replacement is small.
The best treatment for tear troughs is fat injections. Fat is replacing fat that was lost to gravity and age.
Now with microcannulas the results are less traumatic and more predictable.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Fillers in lower eyelids and midface

Thank you for the question. It does not look like you need much enhancement from your photos. There are many effective fillers, but the appropriate choice depends on exactly where you want it placed and how long you want it to last. It is best to first be seen in person by an experienced "expert injector" for a detailed evaluation of your face and discussion of treatment options. Good luck with your filler experience. 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.
All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.

Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Tear trough injection

 Thank you for your question. There are several good options for the tear trough as far as injectable products. What is more important, however, is the qualifications and experience of your injector. I have used Juvederm, Restylane, Restylane silk, and Belotero in this region.  Of these, I have found Restylane to be the most predictable in terms of consistently getting a good result.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 36 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.