All about under-eye filler

EMA client before and after Under Eye Filler

Table of Contents

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 low maintenance solution. Under-eye (tear trough) filler can give the area under your eyes increased volume and reduce the appearance of dark spots. In this article we’ll dive into what types of fillers are used, what the procedure is like, and what under-eye fillers cost.

What is under-eye filler?

Tear trough 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. 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 cheek so it’s important to determine the underlying cause of the deficit before treating. 

It’s also important 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 (the correct level).

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

Most of the softer 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 can naturally lose volume in our tear trough as we age due to volume loss.  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. 

Who is a good candidate for under-eye filler?

A good candidate for under eye filler is someone who:

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


  • A poor candidate for under eye filler is someone:
  • Who has large under-eye bags rather than hollows 
  • Has extremely thin or fragile skin that appears “see-through”
  • Has full-face hollowing and requires full-face intervention prior to under-eye filler

Are tear trough fillers safe?

All medical and aesthetics procedures come with risks. Under-eye fillers done by experienced medical providers can be done safely. It’s important to consult with your injecting provider to discuss the risks and benefits of any procedure. Some of the risks involved in tear trough filler include:

  • A poor result, usually over-filling with a puffy appearance
  • Prolonged swelling from poor product selection or placement
  • A blue tinge under the eyes (tyndall effect) from too much filler, filler placed too superficially or filler placed on a poor candidate
  • A vascular occlusion where dermal filler gets into the artery (angular artery) which can lead to severe complications
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 including any other filler that may be recommended. When combined with other facial fillers the cost for the under-eye portion may be lower. 

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).
  • Not consume alcohol 24-48 hours before your procedure
  • Come to your appointment with a clean face and no make-up if possible. 

You can also consider icing under your eyes for 10-20 min prior to your procedure to decrease the risk of swelling or bruising. You can also consider taking arnica tablets to prevent bruising and swelling. As with any medication or supplement, talk to your provider about any medications or supplements you decide to take.

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 midface, to support the tear trough area and for a better result which takes additional time.

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.

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.

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.

Under eye filler before and after

Ready to book an appointment?

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *