Juvederm filler injected under eye to fill eyelid hollow

How many syringes does it usually take to fill the under eyes area? Does it do anything for the dark circles too? My worry is that I'll have to keep doing it all the time because when the Juvederm goes away, the skin will start sagging a bit.

jademe

F, 33, New York

As we get older, it's common to get under eye bags and experience volume loss in the under eye area.

Not all fillers are appropriate for this delicate part of the face. Compared with other dermal fillers, Juvederm is used less frequently for treating hollow eyes today because it can be too thick for the delicate skin in that area.

The favorite filler among most plastic surgeons for use under the eyes is probably Restylane. Restylane injections under the eyes and in the tear trough area can produce very natural looking results which last up to nine months -- far longer than many other dermal fillers.

Restylane produces extremely natural results, restoring lost volume and, reducing the visual appearance of dark under eye circles.

In my experience non HA dermal fillers like Radiesse and Sculptra can produce uneven, lumpy results in the under eye area.

To answer your question about having to have repeated treatments, that is an understandable concern. All HA fillers are temporary. While some last longer than others, there are no hyaluronic acid-based permanent fillers.

If you are seeking a permanent solution, I suggest you consult with a board-certified plastic surgeon to discuss the possibility of a facial fat transfer. Fat transfer or fat grafting use your own fat cells transferred from another location to restore lost volume. The results can be permanent and extremely natural looking.

Dr. Alexander Ovchinsky has 1 Fillers before & after:

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Juvederm makes excellent dermal fillers but they wouldn't be my first choice for the under eye area.

Every dermal filler is different in terms of viscosity and the way it behaves once injected and, in my experience, Juvederm Ultra is too thick for the thin, sensitive skin of the tear troughs and under eye area.

Juvederm Voluma, on the other hand, is an excellent filler for plumping and creating volume in the cheeks, or for creating extra definition along the jawline. But like Juvederm Ultra, it's also too thick for use under the eyes.

We have had excellent, natural looking results with Restylane Silk which, like Juvederm products, is also a hyaluronic acid filler. Restylane Silk has an excellent smooth consistency and doesn't get lumpy or spread excessively within the skin tissue once it has been injected.

The injection technique with Restylane is a little different than it is with Juvederm. We inject it at a deeper level, quite close to the bone. The result is an injectable filler treatment with less swelling and bruising -- and a shorter recovery period. Because we use flat cannulas, Restylane filler injections cause less bruising and carry fewer risks of unwanted side effects.

Another excellent under eye filler treatment is Belotero Balance. Belotero is a newer product, and is extremely well suited for treating dark circles in the under-eye hollows. Belotero has an interesting consistency which conforms to the physical features of the eye hollow areas and facial features.

Which filler is the best filler for any particular patient is a decision that should be left up to your injector. Experienced injectors understand the different formulations of facial fillers and can recommend which treatment approach will be best for you. Always remember to consult with a board-certified plastic surgeon or dermatologist for best results.

Yes, facial fillers can be used to correct the dark circles in the under eye area. My advice however would be to use something besides Juvederm. Juvederm facial fillers are excellent products and are the HA filler of choice for the upper cheeks and some other areas of the face. But the under eye area can be very unforgiving for thicker consistency fillers like Juvederm.

There are a number of different fillers that work well in the under eye area but Restylane is the go to choice for most plastic surgeons working with eye bags and dark circles under the eyes.

Restylane is a thinner product that is injected just above the level of the bone using a flat cannula. The flat cannula spares the delicate blood vessels while injecting, which results in less bruising and swelling, and a shorter recovery time.

Another excellent dermal filler choice for the under eye area is Belotero Balance. Belotero has a special formulation which uses multiple particle sizes. This formulation makes Belotero excellent for filling in gaps and the results can be very smooth and natural.

Most importantly, I would leave the choice of which filler to use up to your doctor. The decision of which filler to choose depends on the individual patient's facial presentation and the personal preferences and experience of the injector.

Remember, it's extremely important to choose a skilled injector when working with the under eye area and tear troughs. Good technique and a sound understanding of facial anatomy is extremely important for achieving natural-looking results.

Juvederm is a hyaluronic acid based dermal filler which is excellent for adding volume and treating heavy creases. It wouldn’t be my first choice for treating the tear troughs, however, because it tends to be too thick. Juvederm in the under eye area would probably look unnatural, lumpy and uneven.

Some options for correcting volume loss and dark circles under the eyes would be Restylane Silk, Volbella, or sometimes Belotero dermal fillers. I can’t give you any specific advice without a direct consultation, but my first choice would probably be Restylane Silk. Silk is a thinner, smoother product that produces natural-looking, even results.

In most cases a single syringe is sufficient to treat the under eye area.

Regarding your concern that you will have to keep returning to your plastic surgeon for additional eye filler treatments: All hyaluronic acid fillers are temporary. Generally speaking, you'll have to get new filler injections about once per year in the tear trough area. I suggest inquiring about a longer lasting facial filler like Volbella if you are trying to maximize the longevity of your injections. Volbella will last from 12 to 18 months.

Fillers do not directly improve the dark circles under your eyes as this is mostly due to capillary leaking into thinner eyelid skin. However, the hollow area usually accentuates the dark discoloration by causing shadowing, and fillers can improve this by evening out the depression.

Injectable fillers are an excellent solution to fix volume loss and eye bags in the tear trough area.

We typically don’t use Juvederm products in the under-eye region. To replace volume under the eyes, we have had excellent results with Restylane’s newer product “Restylane Silk”.

Silk is similar to the original Restylane filler but has a smoother consistency and is made with smaller particles. Because of the smoother, softer quality of Restylane Silk, we’re able to inject it at a higher level of the dermis, where it can look extremely natural. Our patients have loved the results, plus we've been able to minimize bruising.

Juvederm is an excellent dermal filler for creating volume in other areas of the face and for treating heavy creases. While the choice of Restylane vs. Juvederm is up to your plastic surgeon or dermatologist, we have had far better results under the eyes with the consistency and softness of Restylane.

It’s not possible to say how many syringes of any product we will need without assessing your specific case, but it usually involves no more than one or two injections.

As for your concerns that you will require future treatments to keep your skin from sagging, all filler injections, including Radiesse, Belotero and Juvederm, will eventually fade, although some tend to last longer than others. Our experience with Restylane is that the results last approximately 6 months, which is excellent considering the ease, minimal pain and low risk of the procedure.

It’s important to point out that the aging process doesn’t stop with fillers - it only sets back the clock and slows the progression. So fillers are more an effective treatment to minimize the effects of aging on the face than an actual cure. With this in mind, you would need to continue with fillers every 8-12 months to prevent the appearance of sagging, deflation, or wrinkling facial skin.

Unfortunately there’s no single answer to your question because the amount of injectable filler that is required depends on the situation we are presented with.

Many patients come to us with sunken areas under their eyes where they have experienced major volume loss. Others patients come to us because of a mild “looseness” or dark circles which they want to correct. Each of those situations would require different approaches.

Typically for the under-eye area, we choose Volbella fillers or Belotero fillers as they tend to produce more natural looking results than Juvederm filler in the tear trough area.

While Juvederm is an excellent filler for other areas of the face, it is often too thick for the tear trough area and can produce results which look lumpy or unnatural.

To address your concerns about needing multiple treatments, no hyaluronic acid filler will last permanently. However, Volbella has excellent product longevity - between 12 to 18 months - making it one of the longest lasting fillers that can be used in the tear trough area.

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Not all injectable fillers are appropriate for the under eye area. While Juvederm fillers are great products, we wouldn't use them to add volume to the tear troughs or to treat under eye bags.

Juvederm Ultra tends to be slightly too thick a formulation for the under eye areas and can sometimes look lumpy and unnatural.

Juvederm Voluma is used to lift and restore volume in other areas of the face, and to help contour the upper cheeks and jawline, but it’s too thick for the sensitive hollow area under the eyes.

Restylane Silk and Volbella work better as under eye fillers because they both use thinner filler material, which creates more natural results.

As to your question of how much Juvederm you will need under your eyes, there's no way to answer that without a direct examination -- but in most cases we can use a single syringe.

Be sure to consult with a board-certified dermatologist or facial plastic surgeon who has experience restoring volume in the under eye area.

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There are special types of HA fillers for the tear trough deformities. I prefer Restyle Silk, Belotero-Balance and now off label VolBella. Regular juvederm is to thick for under the eyes in my opinion. But best to seek only in person opinions. And yes it is NOT permanent. Usually twice a year is needed to maintain the results. 

Dr. Darryl Blinski has 1 Restylane before & after:

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Great question. I usually recommend one - two syringes to my patients. This varies depending on the volume loss experienced by the patient. You are right. Juvederm will eventually be reabsorbed into the body so maintenance is required once a year. Another option is fat injections which lasts forever. I advise you consult with a board certified plastic surgeon to discuss your options. Best of Luck to you.

The amount of filler to correct lower eyelids depends on the degree of correction desired but usually one syringe will do. As far as dark circles go filler may actually make them worse. Something called the Tindall effect can result in a bluish discoloration where the Juvederm is injected. This happens because the skin is so thin the light reflects off the filler material and caused the blue color. Yes, Juvederm doesn't last forever so you will have to repeat the treatment about once a year. 

Hi- It can help all of those concerns. It is not a permanent filler which has its advantages and disadvantages. Keep in mind that you will continue to age regardless of the procedure you choose so changes that happen are not necessarily a cause and effect. Good Luck! Usually the tear troughs can be done with one or 2 syringes. 

Typically 1 syringe is sufficient to treat the area under the eye. I do not recommend Juvederm due to its swelling capacity. Other products such as Restylane, Restylane Silk, and Belotero are much more natural in that area. 

Good Luck!

The average patient requires between 0.4cc (the small syringe) and a 1cc syringe to correct the problem. The filler in that area will typically last much longer compared to when it is injected in other parts of the face, about twice as long

For the under eyes we like to use Restylane silk, This product works VERY well !