I did Artefill a few years ago, and this year did Belotero . Don’t know if I just need more or if my body is absorbing it somehow or if I need to do something else?

Dr A’s Answer:
There are a few approaches to volumizing the lower eyelid area. You have already tried one approach which is injecting hyaluronic acids (Belotero). You also had Artefil injected into that area which I would advise against. If the hyaluronic acid products aren’t producing enough change or long enough lasting change, I would recommend a tear-trough implant. These are permanent (but removable) implants much like a chin or cheek implant that consistently and permanently adds volume to your upper cheek/lower eyelid area. Other surgeons shy away from this procedure because of the technical challenges, but I have been very satisfied with the procedure. Another choice is fat transfer which holds the possibility of being “permanent”. I find the inconsistency in the survival of fat transfer, future variability of the fat volume, and the fact that it is almost impossible to undue it that I don’t recommend it.

Of course none of the volumizing procedures effect skin quality. Skin resurfacing procedures are used for this and include various chemical and laser procedures. You would need to be evaluated in person to determine which of these may be most suited to you.