“I don’t want to look tired,” Is the number one request most dermatologists say they hear from patients. And under eye filler is one of the top treatments they’re asked about. But plumping up the tear trough area with injections isn’t a quick fix for every eye area complaint. Here, two leading New York dermatologists explain how the procedure can be used to brighten and erase signs of fatigue—as reveal who can expect the very best results.
Who is a good candidate for under eye filler?
Shadowing under the eyes can happen for a number of reasons. The first thing to know: If your dark circles are caused by pigment or by vascular issues, filler isn’t going to magically erase them. However, if you have hollow half-moon hanging out under your eyes, you’re in luck. “Filler is a great option for people who lack volume under the eyes,” says New York dermatologist Joshua Zeichner, MD. “With age, as fat compartments in the face drop, the under-eye area separates from the cheek, giving a hollow appearance. This also occurs in some young people because of genetics and the natural shape of the face. Fillers can be used to create a smooth transition between the under-eye area and the upper cheek.”
Which filler is best for under eyes?
Because hyaluronic acid fillers “are soft and blend into the surrounding skin,” they create the most natural effect under eyes, says New York dermatologist Robert Anolik, MD, who prefers Juvederm. “Other filler forms have greater risk of clumping after repeated eye blinking or being visible through the surface. HA fillers are transparent, as opposed to calcium-based fillers, which are white.” Two other HA fillers commonly used in the eye area are Restylane and Belotero—though, Anolik says, “there is no filler FDA approved for under eye use. All treatments in this area are considered off-label.”
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What are the risks?
“The contours in this area of the face make it one of the most challenging areas to treat, but when administered by a properly trained dermatologist or plastic surgeon, the procedure is very safe,” says Zeichner. “If the filler is injected too superficially in the skin, it may give a blue appearance known as the Tyndall effect. Fortunately, whether you develop a blue discoloration or are too puffy, these fillers can be dissolved using an enzyme known as hyaluronidase.”
Will there be pain or bruising?
Once you get past the apprehension of having a needle placed that close to your eye, the procedure is relatively quick and painless. For sensitive types, “topical numbing creams can be applied to the area 30 minutes prior to the procedure to minimize discomfort,” says Zeichner. Some post-prick puffiness and bruising, however, is likely. “The area is particularly prone to bruising,” says Anolik, “which makes sense when you think how common black eyes are after trauma.” Swelling usually diminishes within a few days after treatment; bruises improve in one to two weeks. It’s important to avoid blood thinners—including fish oil supplements and aspirin—for at least a week prior to treatment, and many doctors also recommend taking homeopathic arnica supplements to minimize bruising.
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How long does under eye filler last?
“Most HA fillers can last up to a year,” says Anolik, “although this area typically
requires touch ups a couple times throughout the year, mostly as a
result of not wanting to overload the area at each treatment. Too much
filler can look unattractive. There is a careful balance of maintaining just the
right amount.”
How much does it cost?
This will vary depending on what part of the country you live in, and can range from $500 to $1500 per syringe. “Each syringe contains 1ml, which is the equivalent of one-fifth of a teaspoon’s worth of volume,” says Zeichner. And while “in some cases it takes more than one syringe to achieve optimal results,” he notes, most patients require only a single syringe to fill the hollows beneath both eyes.
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