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Injectable fillers for dark eye circles

Posted: 2:39 p.m. Friday, Nov. 21, 2014

By Anita Mandal, M.D.
Question: I had a few consultations for dark eyelid circles and was told that the dark circles are really caused by hollowing under my eyes and fillers can be used for treatment. Every plastic surgeon advises a different filler from Juvederm® to Perlane® to Restylane® to Sculptra®. How can I know which filler is best for me?

Answer: Dark circles under the eyes have varied causes. Before recommending fillers, it is important to determine if the cause of a hollow lower eyelid appearance is from bulging lower eyelid fat, loss of orbital volume or loss of upper cheek volume. These are all common causes. Injectable filler treatments for lower eyelid hollows are mainly done in cases of volume loss in the orbit.

My two fillers of choice for lower eyelid hollows are Bellafill® and Restylane, depending on whether one wishes a temporary or long term filler. I do not typically treat the lower lid hollows with Perlane, Juvederm or Sculptra which are more suitable for less delicate areas of volume loss as in the cheeks.

While both Restylane and Bellafill® can produce effective results with natural volume restoration of the lower lid hollow, Restylane is a hyaluronic acid whereas Bellafill® is a collagen stimulator. Restylane works by attracting water into the area of injection. It lasts about one year in the lower eyelid hollow but can be more prone to causing eyelid puffiness due to its water retention properties. Restylane works better along the part of the lower eyelid hollow closest to the nose, also known as the tear trough, but is not as effective on the outer half of the lower eyelid hollow. In comparison, Bellafill® has the benefits of being long term, less prone to puffiness when injected properly and having smoother results along the entire inner and outer lower orbit hollow.

A thorough consultation with a Board Certified Facial Plastic Surgeon who is skilled and experienced with the many injectable fillers for the treatment of facial volume loss is the first step.


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