Restylane or Belotero under the eyes

A tear trough filler question (under the eyes)

A patient recently called me (who lives relatively far away from Modesto) to see if I can give her a second opinion regarding restylane under the eyes.  She has a local injector (local to her) who wants to inject restylane under her eyes and she wanted to know why we don’t do restylane under the eyes.   Here are some thoughts I had.

I would tell her that I think that any product could work well under the eye in the tear trough region with a skillful injection artist.  The more important factor is the artist who injects under the eye.  There are so many things you can do with a filler (off-label FDA) – such as dilute the filler or add lidocaine/epinephrine or inject deep or use a cannula, etc.

The filler product is like the violin without the violinist.

Restylane in my hands is excellent under the eyes – I have even used it before quite frequently and was very happy with the results.  I personally prefer Belotero because in my hands currently because it results in a smoother contour.  The edges are not as aparent to me if I have some superficial injections.  My technique is usually to inject deep.  But some patients need a thicker fill under the eyes, and thus they would be better served with Restylane – which also lasts longer than belotero under the eyes.

Because of the smoother contours, I prefer belotero under the eyes rather than Restylane.  This is only a personal preference and it is my current preference which can/will change with time and further experience and further feedback from patients.

The reason I don’t carry Restylane, it’s because it’s a product that is very similar to Belotero and Juvederm.  Similar enough that I don’t really see a point in having it in my practice, and I have received poor customer service from the Restylane company in the past, and thus I chose not to carry their products for the past 6 years.

Juvederm under the eyes, in my opinion causes a bluish hue (tyndall effect) in the hands of many surgeons/doctors/injectors including myself.  I have rarely experienced this problem, but because other surgeons have reported this more often than I’d like to hear.  Thus I tend to stay away from Juvederm for under the eyes.

The under eye filling with any filler is consider off-label FDA usage, and thus there won’t be a ton of information about this because companies are technically prohibited from advertising off-label FDA uses of products.

I think she would be fine getting Restylane if she trusts her injector.  I am not able to comment on the skills of other injectors because I don’t know how they inject.   Please continue to see your injector in person for detailed information.  I would welcome another visit to our office to continue the conversation if that were convenient.

Disclaimer:  The above is medical information.  It’s not intended to be advice.  Please see your doctor/injector in person for personalized advice.