What is the Top Tear Trough and Under Eyelid Filler Available?

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Dr. Joel Kopelman

February 22, 2023

The best tear trough and under-eye filler is usually a soft, cross-linked hyaluronic acid filler because it can be placed in small amounts, adjusted carefully, and dissolved with hyaluronidase if needed. The under-eye area is delicate, so permanent or semi-permanent fillers such as Bellafill, Radiesse, silicone, and Sculptra are generally avoided because they are harder to reverse and may cause visible irregularities or long-term complications. The right filler depends on tear trough depth, skin thickness, lower eyelid anatomy, swelling tendency, and the injector’s experience. A careful evaluation helps determine whether filler, cheek support, skin treatment, or surgery is the safer option.
tear trough & under eyelid filler

Best Dermal Filler for Under Eyes: The Safest Choice for Tear Troughs

best eyelid fillerAmong the best fillers for under the eyes, hyaluronic acid products remain the safest and most widely used option. HA gel fillers are soft and pliable, and they can be reversed if any issues arise. The Restylane, Juvederm, and Belotero families of fillers are all made of HA gel and have different characteristics that can affect their suitability for under-eye use. For many patients, Restylane-L remains the best dermal filler for tear trough correction because of its balance of lift, softness, and control.

Apart from Restylane-L, other HA gel fillers have unique characteristics that make them suitable for specific types of under-eye injections. Belotero Balance is more forgiving for injectors but provides less lift, while Juvederm Volbella and Juvederm Vollure are newer, softer fillers with lower swelling but a slightly higher risk of inflammatory nodules. Restylane Refyne and Defyne are more flexible and better suited for areas with a lot of facial movement, but they have not been shown to be superior to regular Restylane for the under-eye area. Restylane Silk is the thinnest and softest version of Restylane, but it has the highest swelling capacity and may not be the best choice for the thin under-eye skin.

What are the benefits and considerations of under-eye fat injections?

Fat Grafting and eyelids

Fat injection is a type of permanent filler that can use your own fat cells to add volume to the under-eye area, similar to injectable synthetic fillers. However, the procedure is typically performed in conjunction with cosmetic eyelid surgery to provide support and blend the areas around the eyes.

While some surgeons may be hesitant to perform under-eye fat injections due to their unpredictable nature, when done correctly, the procedure can be safe and effective. Success heavily depends on the technique used, such as processing the fat in a sterile, closed system and placing conservative amounts of fat in the deepest level with very small fat parcels in each location.

It’s important to note that fat grafting is less predictable than synthetic fillers, as some of the cells being injected may not survive. However, even with a 50% survival rate, the benefits of under-eye fat injections can be worth considering for those seeking a permanent solution. Consult with a qualified professional to determine if under-eye fat injections are the right choice for your unique needs.

Under Eye Filler Options and What to Consider
oculoplastic surgeon for under eyelid filler

It is important to emphasize that choosing the best filler for the under-eye area depends on the patient’s individual needs and the injector’s skill and experience. It is essential to consult with a qualified oculoplastic or cosmetic surgeon to determine the best filler or combination of fillers for one’s needs. An experienced injector can evaluate the patient’s unique situation and select the appropriate filler or fillers to achieve the best results.

When it comes to choosing the best under-eye filler, patients should consider a few factors. Firstly, the experience and expertise of the injector matter significantly. The injector’s skill level can impact the success of the procedure and reduce the risk of complications. Patients should choose an injector who has experience in under-eye filler injections and a good track record of successful procedures.

Secondly, patients should consider their unique needs and expectations. Factors such as the amount of volume loss, the severity of under-eye hollows, and skin thickness can affect the choice of filler. Some patients may require a combination of fillers to achieve the desired results.

Finally, patients should consider the potential side effects and risks associated with under-eye filler injections. Although HA gel fillers are generally considered safe, there is still a risk of complications, such as bruising, swelling, and infection. Patients should discuss the potential risks with their injector and ensure they understand the procedure’s aftercare instructions.

In conclusion, choosing the best filler for the under-eye area is an important decision that requires careful consideration. HA gel fillers, particularly Restylane-L, are the safest and most popular choice for under-eye injections. Patients should consult with an experienced injector to determine the best filler or combination of fillers for their unique needs. Considering factors such as experience, individual needs, and potential risks can help ensure a successful and safe procedure.

About the doctor

Dr. Joel Kopelman

Facial Plastic Surgeon & Oculoplastic Specialist
Dr. Joel Kopelman is a highly experienced facial plastic and oculoplastic surgeon known for his refined surgical technique and meticulous attention to detail. With decades of expertise in facelifts, eyelid surgery, and cosmetic facial procedures, he has built a reputation for delivering natural, elegant outcomes tailored to each patient’s anatomy and goals. He sees patients in both New York City and Palm Beach, Florida, and also offers virtual consultations for patients across the United States and internationally.
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Dr. Joel Kopelman

Dr. Kopelman is a board-certified facial plastic and oculoplastic surgeon with over 40 years of experience delivering natural, elegant results in eyelid surgery, facelifts, and facial rejuvenation. He sees patients in New York City, New Jersey, assnd Palm Beach.

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