EXPERT Q&A

Q: What is preferred injectable for "bags" and dark under eye circles for female aged 45-54? I am trying to decide between Restylane and Belotero.

What our experts say:

To answer this question, it is important to recognize how we use dermal fillers to treat the lower eyelid.  Dermal fillers such as Restylane and Belotero do not treat the “under eye bags” as much as they MASK the prominence of the bags in comparison to the rest of the face. The lower eyelid bags will bulge out, but they are tethered along the lower aspect of the eyelid as it approaches the upper cheek.  When the cheek is also prominent, a line will form between the lower eyelid bag and the cheek.  We call this line the “tear trough”.  Dermal fillers can be used to fill this tear trough, which in turn masks the presence of the lower eyelid bag, and promotes a smooth junction between the lower eyelid and the cheek. Between Restylane and Belotero, I prefer Restylane for the tear trough as I believe it provides a smoother contour along the tear trough, and it does last longer than Belotero.  The main drawback of Restylane is what is called the “Tyndall” effect, which refers to a bluish tint to the skin that can occur after injection.  If you have pre-existing pigment, I would probably recommend Belotero in your specific case.  In the absence of pigment, however, I would use Restylane.

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Dr. Alan J. Durkin

Plastic Surgeon

Vero Beach , Florida