Best dermal filler for under-eye hollows

Any filler can be used in the tear trough, but I think Restylane is the best for this area. Juvederm can be used but it tends to cause more swelling, probably because it has a higher concentration of Hyaluronic Acid than Restylane. Perlane is too thick for this area. Radiesse is hard to use in this area. The skin is VERY thin, Radiesse is very thick. If you get a lump with the Radiesse it is going to be there for a long time. I would not advise that you even try Sculptra in this area because the potential for lumps developing over time is too great in this area.

Michael Sinclair, MD

Hi Hot Nani in Hotlanta,

I went to medical school in Atlanta, so I will try to answer your question with Emory pride.  I have used both Restylane and Juviderm for facial filling; they are both very good hyaluronic acid filler products.

Under the eyelid in the tear trough depression area, I have again used both fillers.  I have found that Restylane is most dependable in that what I put in won't go "crazy" with puffiness and swelling.  I have not had any problems at all with Restylane in this area.  On the other hand (or tear trough hollow) though I have treated a few patients with Juviderm in this area, after my second patient had swelling and edema (with identical technique and under correcting) I have stopped using Juviderm there. Most of the patients looked great, but I found Juviderm to be unpredictable in this sensitive area.  Many other facial plastic surgeons have shared similar experiences with me.   I am not a speaker or representative for either company.  Make sure that you choose your experienced physician carefully for injections in this area.

Once successfully in place, Restylane in this area has impressed me with it's longevity of up to and many times longer that one year.

William Silver, MD in Atlanta is a very well respected facial plastic surgeon.

Be well.

Dr. P

There are certain fillers that are safe for hollowing under the eyes.  Typically, the hyaluronic acid products such as Restylane or Juvederm can fill in the hollowing of the lower eyelids very nicely.

The eyelid skin is some of the thinnest skin in the body so you want to make sure the injector is comfortable with the eyelids so as not to cause too much lumpiness or stranding. I usually recommend to my patients that they try a non-permanent filler always before a permanent filler to make sure they are pleased with their result and have no adverse reaction.

These hyaluronic acid products are very safe products and when used judiciously can eliminate the hollowed appearance the lower lids can take on with aging as we lose fat.