juvederm, artefill or fat under the eyes for eye hollows

Hi Dr. Rivkin,

Not being too familiar with the fillers OR fat grafting, and getting confused reading on them, I have a few questions.
I have what I feel are excessive undereye hollowing and darkness, I feel due to a combination of an agressive lower Bleph 13 yrs. ago. I was only 44 but had hereditary heavy puffiness. It looked great until about 4 years ago. I was very happy with it. Now I look very tired, just "hollow". Makeup just won't cover it, it's just too deep.
Is it a better idea to give something more temporary a try first, then go on to something more (hopefully) permanent like fat grafting for that area? Or is Artefill too new or last too long for that area, and is there something better milder, I guess you might say, to use for that area?
I know that's a lot of questions, but I just wanted to know what your thoughts might be in that case, in your experience.
Thanks!


hi,
i really like juvederm or restylane under the eyes. it lasts for a really long time (1.5 years) and the results are really smooth and natural looking if the person who does it is experienced in the procedure. it is, technically, a somewhat difficult procedure to perform. the advantage of juvederm and restylane is that they can be dissolved easily with an enzyme. so, adjustments after the procedure are easy to do.
artefill does not belong under the eyes. the chances of a bumpy result is too high and there is no way to get rid of it besides surgery.
fat grafting, when done very well, works nicely. however i have seen too many poor results. it is not always done very well and if you get a bad result, it is very difficult to fix.