Retin-A is a wonderful product that I recommend to virtually every one of my patients; however, I do not recommend it for wrinkle reduction and certainly would not recommend it for under eye hollows. Retin-A essentially increased the cellular turnover of the skin. It can provide a very small amount of very fine wrinkle reduction, but this would be very difficult to really appreciate visually. Fillers; however, are excellent at filling in depressions in the under eye if placed extremely precisely and carefully. Products such as Restylane or Juvéderm Ultra can do a wonderful job of filling in these troughs or depressions in the lower eyelid and this will essentially give the illusion that the lower eyelid bag has disappeared. This can create a very natural rejuvenated eyelid appearance without surgery. The only two drawbacks are that it is not a permanent solution, but will last approximately one year. The other drawback is that if not placed properly, can actually create a worse problem than the original under eye hollow. Fortunately any sort of difficulties with over injection of these types of products can be treated rather easily and therefore any complications from filler material in the lower eyelids can be corrected with injection of hyaluronidase.
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