Let’s say a woman is bothered by puffy lower eyelids, or dark circles under the eyes, and she comes in for a consultation to discuss eyelid surgery at our Portland, Oregon, practice. She might be surprised to learn that in certain cases, injectable fillers like Restylane® and JUVÉDERM® might be a better treatment approach than having surgery.

Fillers and BOTOX® Cosmetic injections offer the right candidates nonsurgical options for aesthetic concerns around their eyes. The tradeoff is that the results are temporary. For men and women seeking long-term solutions, eyelid surgery (blepharoplasty) is a tried-and-true procedure with an excellent track record.

So, how do you know whether eyelid surgery or treatment with dermal fillers is best for you? This post addresses that question by explaining the characteristics that warrant choosing one procedure or the other, along with briefly describing what to expect during treatment and recovery.

Dermal Fillers

Dermal filler injections are a popular nonsurgical facial rejuvenation option that we often combine with BOTOX at MDBeautyLab to address forehead wrinkles, crow’s feet, dark circles, and undereye bags. Fillers such as those from the JUVÉDERM® and Restylane® product lines are gels of varying consistencies that work by reversing age-related volume loss. They can be effective for patients with dark circles or small bags under the eyes.

BOTOX is not a filler. It minimizes the appearance of wrinkles around the eyebrows by temporarily immobilizing the tiny facial muscles that contract each time someone squints, smiles, frowns, or otherwise changes facial expressions. A lifetime of these movements gradually causes wrinkles to form. BOTOX also provides a subtle lift to the corners of the eyebrows.

A good candidate for injectable fillers and BOTOX has minimal or no excess skin and no brow sagging, but has a desire to smooth out wrinkles around their eyes, brows, and forehead. Injectable treatments don’t require downtime, but you can expect some swelling and redness in the first 24 hours after the injections.

Eyelid Surgery

We can perform upper or lower eyelid surgery, or both, at our Portland plastic surgery practice to address sagging brows and excess skin and fat in the eye area that detract from the natural attractiveness of your eyes. Blepharoplasty can be truly transformative for patients of all ages, creating a more alert and rested appearance for individuals whose sagging brows make them look tired or angry all the time. In some cases, sagging brows can even partially obscure patients’ vision.

The techniques used for upper and lower eyelid surgery are different, but in both cases the incisions are concealed in the natural folds of the lids. Our surgeons may choose to make lower blepharoplasty incisions on the insides of the lids. Lower eyelid surgery combined with filler injections can provide optimal results.

We recommend patients wait 10 days after eyelid surgery before resuming normal activities, and up to 3 weeks before engaging in strenuous exercise. Most patients can control discomfort with either prescription or over-the-counter pain relief medication.

Request Your Consultation

If you want to learn more about the differences between these procedures or other surgical and nonsurgical facial rejuvenation treatments we offer, request a consultation online or give us a call.


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