All about under eye filler

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Introduction: All about under-eye filler

Have you gotten tired of trying under-eye creams hoping that they would help you get rid of the dark sunken look under your eyes? For many clients this area is extremely frustrating, but the good news is that there is a solution. Under-eye (tear trough) filler can give the area under your eyes increased volume and reduce the appearance of dark hollows. In this article we’ll dive into what types of fillers are used, what the procedure is like, and what under-eye fillers cost.

For visual learners, watch this YouTube video that features NP, Ali Wagstaff, and her take on under-eye concerns and treatments to help. 

What is under-eye filler?

Tear trough filler (aka under-eye filler) is a treatment where hyaluronic acid (HA) dermal fillers are injected using a needle or cannula into and around the dark hollows under the eyes. It can be done alone or in conjunction with cheek filler. 

Why is under-eye filler sometimes done with cheek filler?

It’s important to address the whole face when treating this area for a natural and balanced look. Oftentimes under eye hollows can be from loss of volume in the cheeks. Always determine the underlying cause of the deficit before treating.

Also, it is crucial to go to an experienced provider, as this area can not only be dangerous to inject, but also difficult to inject in the correct plane (or level).

Below is a before and after photo of a patient who needed cheek support along with under eye correction. The two go hand-in-hand.

What types of filler can be used in the under-eye region?

Most of the softer, thinner HA (hyaluronic acid) fillers can be used in the under-eye area. Sometimes firmer HA’s can be used in severe cases, or when they are diluted. It is not advised to use non-HA fillers in this thin, sensitive area. 

The most commonly used hyaluronic acid fillers for under-eyes are:

Other fillers such as collagen, Sculptra and Radiesse are NOT recommended in this area due to risk of overfilling, pain, reaction and nodules. This is a high movement area that needs a soft and gentle HA filler for best results.  

For more information on fillers, check out our filler guide.

What does tear trough filler treat?

Our bodies naturally lose volume in our tear trough as we age. We also have separation of the fat pads under the eyes and the cheeks. This leaves an indentation, or dark hollowing, under the eye which can be softened with dermal fillers for a more refreshed “awake” appearance. Below are some before and after photos that help visualize tear trough filler.

Who is a good candidate for under-eye filler?

A good candidate is someone who:

  • Has always had dark under eye hollows genetically 
  • Developed dark under eye hollows with aging 
  • Has good skin quality & cheek support

A poor candidate is someone who:

  • Has large under eye bags rather than hollows
  • Has extremely thin or fragile skin that appears to be “see-through”
  • Has full face hollowing and requires full-face intervention prior to under eye filler

If you previously had a poor under eye filler treatment, and don’t know what to do, be sure to schedule a free consultation! In the mean time, read how you can reverse “bad” filler.

Are tear trough fillers safe?

Yes, under-eye fillers done by experienced medical providers can be done safely. It’s important to consult with your injecting provider, like our Nurse Practitioner Ali, to discuss the risks and benefits of any procedure. See below for risks

Are there risks involved with under eye filler?

All medical and aesthetic procedures come with risks. Some of these risks involved in tear trough filler include:

  1. A poor result, usually over-filling with a puffy appearance
  2. Prolonged swelling from poor product selection or placement
  3. A blue tinge under the eyes (tyndall effect) from too much filler, filler placed too superficially or filler placed on a poor candidate
  4. A vascular occlusion where dermal filler gets into the artery (angular artery) which can lead to severe complications

Below is a photo of the facial anatomy to demonstrate how important it is to go to a trusted/licensed provider for under-eye procedures.

Vascular system for under eye fillers
Image Courtesy of Plastic and Aesthetic Research

What are the benefits of tear trough filler?

  • Tear trough filler can add volume to lessen the “hollowness” under the eyes
  • It can give you a more rested and youthful appearance 
  • Filler will diminish under-eye bags (in certain cases) 
  • It will eliminate or lessen dark circles under the eyes

How much does under-eye filler cost?

Under-eye filler varies in cost based on the type that you receive, where you have the procedure done, and who is performing the procedure. Below is a breakdown of the cost, on average.

  • Hyaluronic Acid Fillers like Juvederm, Belotero, and Restylane generally cost between $600-$1200 per treatment. This does not include any other filler that may be recommended. When combined with other facial fillers the cost for the under-eye portion may be lower. 

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How do you prepare for under-eye filler?

Talk to your injecting provider for a complete list of instructions, but in general, it will likely be recommended to:

  • Avoid over the counter medications that may thin your blood like aspirin, ibuprofen, fish oil  (unless prescribed)
  • Do not consume alcohol 24-48 hours before your procedure
  • Come to your appointment with a clean face and no make-up (if possible) 

Some additional recommendations to help you prepare:

Taking arnica tablets help to prevent bruising/swelling, too (as with any supplement, talk to your provider before you take OTC medications or supplements)

Consider icing the under eyes for 10-20 minutes prior fo your procedure to decrease the risk of swelling/bruising

What is an under-eye filler treatment like?

Under-eye filler appointments are generally about 30-60 minutes. The actual procedure itself may only take about 5-minutes per side, but the preparation and discussions prior to the appointment will take up extra time. Your injector may also recommend injecting other areas first, such as the cheeks and mid-face, to support the tear trough area and for a better result which takes additional time. 

If you are curious about what our filler appointments generally look like, read our blog here. The more you know, the more comfortable you can be (:

What is under-eye filler aftercare like?

Every injector will have their own specific aftercare instructions. Below are some of the general recommendations for under eye filler aftercare:

  • Try to avoid using concealer or other eye makeup for the first 24 hours.
  • Do not rub the treated area for at least 24-48 hours after your injections. 
  • Avoid intense physical activity for 24-48 hours, if possible, as exercise may increase swelling to the area treated
  • Consider avoiding alcohol for 48 hours after your treatment. Drinking could increase the swelling and bruising.
  • Use an ice pack to ice the area for 5-10 minutes off and on for the first 48 hours. This will help you reduce  swelling quicker. It’s also a great reason to sit on the couch and relax.

For more tips and tricks on how to avoid swelling from filler, in general, read this

When will I see results from tear trough filler?

Immediately after the procedure you will be able to see your results! For many people, there will also be some swelling immediately post-procedure. The swelling will start to go down in about 48 hours. You will be able to see the final results in 7 to 14 days in most cases but in rare cases, it may take longer, especially during allergy season.

How long do under-eye fillers last?

Over the years we have discovered that filler tends to last much longer in this area than in other high movement areas. Lasting even longer than the lips. The same filler brand that may only last 6-8 months in the lips may last 1-2 years under the eyes.  More cross-linked fillers, such as the Juvederm family, can last 2-3 years, but this does come with an increased risk of reactions and late-onset nodules. Talk to your injecting provider about what dermal filler is best for you. Schedule a free consultation HERE.

What is the best under-eye filler?

Hyaluronic acid fillers are the best fillers for under-eye treatments and we have tried almost all of the available brands on the U.S. market. Our favorites have been Belotero Balance and Restylane-L for most cases. 

We also use other, firmer HA fillers or Radiesse in the cheeks prior to doing under-eye fillers to support the area and also give a more natural look. 

For a full list on fillers and what areas they’re best for, READ THIS!

Is tear trough filler worth it?

Yes, tear trough filler is worth it. This is one of the procedures that we get excellent feedback on. It’s a subtle result that makes a huge impact for clients that feel like they constantly look tired. It also has minimal downtime and is not obvious to others that it was done. 

Under eye filler before and after

Conslusion

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