Belotero or Restylane under the eye?

Both Belotero and Restylane work better than most other fillers directly under the eye as neither absorbs much water and, therefore, there is less problem with swelling after injection. I have, however, almost stopped using either there because of the occasional swelling. Instead, I try to stay a little lower and fill the tear trough and other depressed areas under the eye by pushing the cheek area up with Juvederm Voluma. This elevates the cheek back to where it should be and will frequently totally correct the under eye problem. Only in those instances where it does not do I use Belotero or Restylane.

Neither Belotero or Restylane should be injected under the eye. The results are unpredictable. I have yet seen any physician who can provide even half a dozen before and after photos of patients who have archived a beautiful, natural result with either restylane or Belotero. I think consumers should look for dozens of before and after images before making a long term change to their appearance. In some cases, the damaging effects of under eye injections can be permanent. The only material I use for under eye enhancement is structural fat grafting using a patient's own fat. I have many, many before and after images of patients who have received fat grafting. These photos range from weeks, to months, to years after the treatment has been performed. Structural fat grafting is the placement of fat - harvested using a syringe aspiration technique from a remote location on the trunk or thighs – into an area of hollowness or soft tissue deficit using small syringes and small blunt cannulas. As needles are not used, fat grafting is technically not an ‘injection’. The key to success with structural fat grating is the meticulous placement of small amounts of fat (tiny globules) diffusely throughout the area that is being enhanced.

Belotero or Restylane - Both of them are excellent Fillers for under the eyes. If placed in the right position, they work well and are long-lasting.

Currently, I prefer Belotero for this area. There is less swelling, and less of the blue-ish Tyndall effect that can be sometimes seen with other HA fillers.

Both Belotero and Restylane work well. I agree with Dr. Buchanan in that I prefer to use Voluma to raise the midface first, then touch up with a finer HA filler.

Both Belotero and Restylane are hyaluronic acid fillers that can be used effectively in the hollows under the eye when injected judiciously at the proper anatomical level in the appropriate patient by an experienced plastic surgeon. Restylane generally lasts longer than Belotero.

Robert Singer, MD FACS
La Jolla, California