- Under-eye fillers add volume underneath the eyes for a youthful look and to improve the appearance of fine lines, puffy eyes and some dark circles.
- Fillers are generally safe and provide immediate results that last from six months to one year, on average.
- Under-eye fillers cost anywhere from $600–$1500 and up.
With age, skin naturally loses collagen and elastin which results in the formation of wrinkles and fine lines. While there are many over-the-counter treatments that can address these concerns, none are as effective as under-eye or tear trough fillers.
Under-eye fillers add subtle volume to this targeted area, providing a smoother, more youthful appearance.
What Are Under-Eye Fillers?
Tear trough fillers, or under-eye fillers, are essentially off-label dermal fillers – meaning they are being used in a different manner than originally intended. These injectable fillers have been FDA-approved for on-label uses, but not specifically for use under the eyes. However, they are still considered safe as under-eye fillers.
Under-eye fillers are injected just below the eye to add volume to the immediate area. The fillers work to smooth out fine lines and wrinkles, plump and even out any sunken areas and reduce the appearance of puffiness.
Tear trough fillers are the most effective way to reduce any sunken or dark areas under the eyes and reduce the appearance of under-eye wrinkles. Multiple studies have demonstrated that hyaluronic acid-based fillers are generally safe and incredibly effective at adding volume to the under-eye area, resulting in a smooth, youthful appearance.
Treat trough fillers can also help reduce the visibility of some under-eye dark circles and eye puffiness, but only if they’re the result of a loss in macular volume and not a result of hyperpigmentation. If hyperpigmentation is the cause of dark under-eye circles, there’s a risk that tear trough fillers could make the discoloration more pronounced.
Types of tear trough fillers
There are multiple types of temporary and semi-permanent tear trough fillers to choose from. Temporary fillers last between six and nine months; they’re biodegradable and will lose their effects more quickly than semi-permanent fillers, which can last up to one year.
Hyaluronic acid (HA) fillers are the most common temporary fillers used for tear troughs. HA has natural plumping characteristics and boosts collagen production in the immediate area. Injectable treatments such as Restylane, Juvederm, Perlane and Belotero are commonly used for this purpose.
A tear trough filler procedure may be performed using fat grafting or fat transposition. That means your provider will take fat from another part of your body and inject it beneath your eyes.
Commonly-used tear trough fillers made from HA and fat are reabsorbable, meaning they naturally absorb into the surrounding tissues over time and need to be reinjected periodically.
Semi-permanent, non-HA under-eye fillers include Bellafill, Radiesse and Sculptra. Each is made from a different dermal filler material.
- Bellafill is a combination of polymethyl methacrylate (PMMA) and bovine collagen solution
- Radiesse is a calcium hydroxylapatite gel filler
- Sculptra is made from poly-L-lactic acid
Some under-eye fillers have lidocaine mixed into the syringe to ease discomfort.
What to Expect During the Procedure
An under-eye filler procedure is typically a relatively quick process. You’ll be asked to arrive at your appointment makeup-free. The healthcare provider will cleanse your skin with a medical grade cleanser, and apply a topical numbing cream to the area so that the procedure is more comfortable. You’ll be allowed to sit up throughout the process.
About ten to twenty minutes after applying the numbing cream (often topical lidocaine), the provider will inject the area using a needle or a cannula – a small, thin tube inserted under the skin to deliver the filler. Needles may be more precise, although cannulas have a lower risk of postprocedure bruising.
The provider will slowly inject small amounts of filler to each area, until the desired result is reached. This reduced speed also minimizes any potential swelling. Many providers will form the product with their fingers immediately after it’s injected, shaping it before it sets completely.
The injection process typically lasts about 15 minutes; immediately following, your provider will apply ice to the area. to reduce bruising or swelling. The entire appointment will likely be complete within 45 minutes to one hour.
Recovery and aftercare
It’s common to experience some swelling and bruising immediately following the injection of tear trough fillers. This typically won’t last for more than two days, but some bruising may last up to a week. Some soreness around the eyes is also common.
Immediately following your procedure, avoid touching the area for at least 24 hours. Don’t use any makeup or skin care products until the following day to prevent potential infections. Aim to ice the area in ten-minute sessions every few hours for the first day, and take a day off from any workouts that could raise your heart rate.
You should be able to resume normal activities within 24 hours.
The results of tear trough filler injections will vary from one person to another, depending on their unique condition and the type of filler used.
When are results visible?
Results are visible immediately following the procedure, although some swelling may make it difficult to discern right after you receive the injections.
How long do tear trough fillers last?
Most hyaluronic acid-based tear trough fillers last between six months to one year for the average person, but may last longer for some. It depends on each individual person and how quickly the filler is absorbed back into the body.
Side Effects and Complications
The most common side effects of tear trough fillers include swelling, bruising, and some soreness or discomfort following the procedure. These are all typically short-lived; soreness will usually resolve by the day after the procedure, and swelling should be minor and only last for a few days.
It’s possible for under-eye filler procedures to yield unsatisfactory results. The area beneath the eyes may look uneven, asymmetrical or puffy. If that’s the case, your provider should be able to take corrective action by.
- Messaging the under-eye area to more rapidly absorb HA fillers
- Injecting the enzyme hyaluronidase for HA fillers to dissolve the filler
- Additional injections in surrounding tissues to even out the look of the skin for non-HA fillers
- Surgical removal of non-HA tear trough filler that has created an irregular or uneven texture
There are other risks associated with under-eye fillers that, while uncommon, should be kept in mind when considering treatment:
- Postprocedure infection, which may require antibiotics and may even occur up to six months following a procedure
- Sensitivity reactions, which may also develop long after the procedure, and involve redness, swelling and soreness
- Increased appearance of hyperpigmentation, especially in the area being treated
- Vascular risks such as occlusions, which can result in skin discoloration
- Puncture of a blood vessel, which can cause an ocular occlusion, resulting in partial or full blindness in one or both eyes
While it’s rare to experience severe side effects as a result of tear trough fillers, the risks are worth considering.
Cost of Tear Trough Fillers
The cost of tear trough fillers varies widely depending on a number of different factors. These include location, the office you choose, the type of filler and the number of vials required to complete the procedure.
Tear trough fillers typically have an average cost of $950, but they may cost as low as around $600 or up to $1500 or more depending on your provider. One vial of Restylane, for example, costs around $250, and the procedure fee will be added on to the cost of the filler themselves.
How to pick a provider
For the best outcome, choose a provider who specializes in tear trough filler procedures. Dermatologists, plastic surgeons and even some optometrists can perform these procedures and are typically more experienced than providers who offer under-eye fillers in salons or spas.
Tear trough fillers may not be the treatment of choice for everyone. Fortunately there are other alternatives although each has its pros and cons that need to be considered.
There are several anti-aging creams that contain high quantities of hyaluronic serum, which can plump up skin when applied topically. These serums or creams are typically more short-lived than fillers and won’t have the same dramatic effect, but they often cost less and don’t come with the risks associated with fillers.
Over-the-counter creams that contain antioxidants, retinoids and peptides (including collagen peptides) may also help to plump the skin in the tear trough area, reducing the appearance of hollows or dark circles.
Skin tightening or eye lift surgery
If the area beneath your eyes doesn’t respond to tear trough filler injections, your provider may recommend a skin tightening procedure or eye lift surgery.
Laser skin resurfacing is one option for tightening the skin under the eyes. Depending on the type of laser used, you may have a thin layer of skin removed from beneath your eyes to encourage new skin growth and new collagen production. Alternatively, other lasers simply heat the skin, encouraging tightening via new collagen production.
Eyelid surgery is more invasive than under-eye filler procedures. Your provider may remove excess skin from the area below your eyes, perform fat grafting or a combination of both. Surgical procedures carry more risks, cost more and require a longer recovery period than injectable fillers – up to three weeks.
Corrective cosmetic surgeries, while not permanent, may have longer-lasting results than dermal filler injections with proper skin care.
Tear trough fillers are a quick and effective solution to reduce the appearance of hollows, bags or dark circles under the eyes. They’re more cost-effective than most surgical procedures, have fewer risks and shorter recovery times, and their results will be more significant and immediate than over-the-counter creams.
Your provider may choose a tear trough filler made with hyaluronic acid, polymethyl mmethacrylate (PMMA), collagen, calcium hydroxylapatite or poly-L-lactic acid. Fillers made with HA are considered temporary, while other filler materials are semi-permanent and may last for up to a year.
Finding a quality provider experienced with injectable under-eye fillers will be key to getting ideal results, so take some time to do research before booking an appointment.