Dr. A’s Answer:

Wrinkles in the lower eyelid skin can not be treated with Juvederm or any other filler. The skin in the lower eyelids is very thin and any filler product placed into that skin would be irregular and would cause a bluish cast called the tindall effect.

You can, however, use fillers in the lower eyelids for tear-troughs. Unlike skin wrinkles, tear-troughs are structural in nature. . . a combination of fat and bony anatomy. The filler is placed deep, under muscle and fat where it won’t show through the skin. While I prefer Restylane for that, the concept is the same for Juvederm. The hollow or “trough” that occurs between the eyelid and the cheek casts a shadow and produces a dark circle. You may also have a purple cast to the skin in the same area and that requires makeup, but the filler will get rid of the shadow problem which makeup can not fix.

Treating the fine wrinkles in the lower eyelids generally requires a resurfacing procedure. Either a laser or chemical peel that is done aggressively enough to cause collagen remodeling. To really get a good result, you usually have to put in a good bit of healing time as more superficial peels really don’t fix the wrinkles. Sometimes Botox or Dysport can help these wrinkles, it will depend on the exact nature of your problem.