What fillers are good for treating under eye hollows or is fat transfer the best treatment?
This is my opinion, but the best filler for under-eye hollows, orbital grooves/tear troughs, is Restylane. Autologous fat transfer is also an excellent treatment, but we usually reserve that treatment for individuals with the need for more volume rejuvenation than just under the orbital groove. Regarding fillers, we feel that hyaluronic acid fillers (eg. Restylane/Juvederm) are definitely the best for under the eyes because they are soft, can be injected with very small needles, last about 1 year, and in the worst case are reversible with hyaluronidase. We prefer Restylane for under the eyes because Juvederm can in some cases draw too much water into the area and lead to a puffy appearance. This is the same reason we prefer Juvederm for lip enhancement. Sculptra is not appropriate for the thin skin under the eyes, but is very useful for overall volume enhancement of the face and can be combined with Restylane. Radiesse can also be used under the eyes, but tends to be more firm, can be more lumpy and is not reversible. Autologous fat is the best treatment for the patient with isolated hollows who is looking for a long-lasting result and doesn’t mind the down-time fat causes which is about 2 weeks. For over all volume replacement, fat is by far the best as long as you can do the down-time. It affords impressive results and lasts 10 years or longer. For patients who cannot afford the down-time we offer a combination of Sculptra and Restylane.
Posted by Dr. Buckingham