Is Restylane really safe in the tear troughs?

I would not recommend Restylane in the tear troughs. A patients' own fat by means of structural fat grafting if the only material I would use for under eye fillers. Look at many before and after photos before electing to have a surgeon make a permanent change to your appearance.

Restylane is relatively safe. However, in some cases it might cause a blueish discoloration due to it being monophasic. This is called tendal effect and it tends to happen in a lesser percentage of biphasic HA products. Consider an ASAPS member for this procedure and raise this issue with him/ her and measure your risk/ benefit ratio before making your final decision.
Best,
Shady Hayek, M.D.
Beirut, Lebanon

Restylane has been used successfully for this situation. Other HA fillers may be better options. A great deal depends on the experience of your treating doctor and your exact clinical situation. Dark circles may be due to other causes than a contour deformity. It is best that you speak with an ASAPS member to address your concerns who has experience with treating "dark circles" in the lower eyelid region so that you understand all of your options.

Hope this helps!