Under eye filler hasn’t always been a super well known or popular treatment, but that’s been changing more recently.
We are so impressed by the many different applications of filler and what a big difference just a small amount can make. However in recent years, we’ve seen some really (and we mean REALLY) bad uses of hyaluronic acid (HA) based fillers. Poor patient selection, poor understanding of facial anatomy, poor placement, and poor product selection can make the under eye area a very challenging area to treat well.
Done correctly, it can make a HUGE difference in a patient’s overall look. There is a misconception out there that filler in the under eye or tear trough area is the right approach for pretty much anyone. However, fewer people than you might expect are actually good candidates for under eye filler. Not to mention the injector’s technique, experience, and skill set all play a role in delivering a great result. So here’s what you need to know.
Under Eye Filler Gone Wrong
Whether it’s genetic or due to aging, pretty much all of us will get that tired look under our eyes at some point. Over time the support structure of the eye weakens, the skin becomes lax, and we lose volume in the face, which causes the surrounding fat pads to deflate and also to drop, creating these little puffy bags just above our cheekbones.
Other things happen too. For some of us our eyelids might begin to droop, or our cheeks begin to deflate and sag, we lose volume in the temples. Basically, there are a myriad of factors that might be contributing to tired looking under eyes, but this doesn’t necessarily mean that it’s the under eye that needs the treating.
The thing with the under eyes is that you have to assess what it is that’s making them look tired. It could be so many things. It could be bags under the eyes, dark circles, hollowness, and whatever the reason, one of the most important factors that will contribute to a great under eye filler result is your injector’s judgment as to whether you are the right candidate for tear trough filler at all.
And if you happen not to be, this is where the results can go very wrong 😬
It is so easy to make this area look puffy if filler is not what you need. Like we mentioned before, sometimes what we perceive as hollowness or darkness under the eyes is actually the result of volume loss in the cheeks or temples. It’s also really easy to overdo this area and cause more puffiness due to compressing the sinuses.
Another thing that happens is that some patients actually have something called malar edema, which basically means that they have weak lymphatic drainage under the eyes. If this is the case, when filler is injected in the area it will accumulate with fluid causing a perpetual puffy look just above the cheekbones where we normally see those under eye bags, making things look worse and not better.
How do I know if I’m a good candidate for under eye filler?
So how do you know if you’re the right candidate for under eye filler? This is the key to a beautiful result and this is where a good injector with a lot of expertise and knowledge of the overall anatomy of the eye area is going to guarantee a good outcome.
But in general, the best candidates for under eye filler are patients who have true hollows or depressions under the eye, and also relatively good skin quality and tightness in the area. When a patient has an actual depression under the eye and good skin quality then it’s easy to fill the area and for the skin to maintain the filler in place. If a patient has too much skin laxity in the area, filler can unfortunately end up looking lumpy.
If you have actual bags under your eyes, filler will more likely than not exacerbate this problem and not help with it. It’s really difficult to inject enough filler around the bags in order to make them appear even with the rest of the face. Really what’s happening is that you’re just creating more puffiness rather than camouflaging the existing bags.
What are some other treatment options to improve the under eye area?
So if under eye filler isn’t the right treatment option for you, what is?
Depending on your needs, we often recommend starting with the least aggressive approach. If you’re someone who has a kind of general darkness around the eyes, or if you have a bluish tinge under the eyes, these concerns are often better treated by PRF (platelet-rich fibrin) injections in the under eye area. It’s a good idea to always start with PRF and then work your way up, so to speak, if you need to.
PRF injections are really the most natural approach to treating the under eye area. By injecting fibrin drawn and separated from your own blood, collagen production is stimulated as well as skin regeneration and new skin cell turnover, resulting in an overall brightness and rejuvenation of the under eye area.
If under eye bags and skin laxity as opposed to darkness or a hollowness under the eye is what you’re trying to combat, then a treatment like AccuTite may be better suited for you than filler. AccuTite uses RF technology in order to shrink tissue and melt fat below the surface of the skin, and particularly in the delicate and sensitive under eye area. The result will be a diminishing of the bags and an overall tightening of the skin.
So as much as we love our fillers for a variety of indications, it may not necessarily be the treatment for you when it comes to your under eyes.
