Everything You've Ever Wanted to Know About Under-Eye Filler (But Were Afraid to Ask)

woman with clear skin
Stocksy+Byrdie

If you deal with puffy eyes or dark circles, there’s a pretty good chance that the words under-eye filler have popped into mind. And hey, we don’t blame you. Under-eye filler is an extremely popular facial rejuvenation injectable designed to deliver your ultimate under-eye goals. But, the question is, is it effective? And, more than that, is it safe?  To find out just that, we chatted with a few of the industry's top dermatologists and plastic surgeons for everything there is to know about under-eye filler.

Meet the Expert

  • Dr. Mary Lynn Moran is a facial plastic surgeon and president of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)
  • Dr. Dendy Engelman is a board-certified dermatologist, Mohs surgeon, and a Byrdie Beauty & Wellness Review Board member.
  • Dr. Anne Chapas is a dermatologist and the the medical director of Union Square Laser Dermatology.

What Is Under-Eye Filler?

Under-eye filler—also known as dermal filler or soft tissue filler—is a hyaluronic acid injection used to improve the appearance of sunken or discolored under-eye areas. While dermal filler is not technically FDA-approved for use under the eyes, dermatologists near and far extend its use (which is designed for cheeks, lips, and hands) thanks to its ability to completely reverse dark circles and bags. 

“Many people develop dark circles under the eyes, which are shadows that are created either by bulging fat directly underneath the lower lid or by depression of soft tissue over the bone underneath the eye,” explains Moran.“In both cases, the shadow can be reduced by placing soft tissue filler within the shadowed area.” 

Thanks to the small surface area of the under-eye region, this rejuvenating procedure doesn’t require loads of injections. That said, even at just one to two syringes of filler per session (to cater to both eyes), Engelman says that you’re looking at around $1,500 per syringe, meaning one treatment—which Engelman says lasts up to 18 months—will cost you around $3,000.

Of course, where you go to get your under-eye fillers plays a role. As Moran points out, some offices only charge between $500 and $900 per syringe, though location (think: city versus suburb) has something to do with that. 

As hefty as the price tag may seem, many folks believe under-eye fillers to be well worth it. After all, unlike some facial treatments that take time to settle into place, the benefits of under-eye filler are noticeable as soon as it’s injected (though, Moran warns that some swelling or bruising may take place). 

Benefits of Under-Eye Filler

  • Immediate results
  • Brighter under-eye area
  • Plumper under-eye area
  • Overall more youthful, less tired-looking under-eye are

There’s a reason why so many people consider under-eye fillers to be the one-stop-shop for looking bright-eyed and bushy-tailed. According to Chapas, most of her patients feel like they look fresher and more awake within hours of their appointment. “They report having to use much less concealer and makeup to cover up undereye circles,” she adds.

The reason these results are even seen is due to what hyaluronic acid injections—such as Belotero, Juvederm, and Restylane—actually do for the under-eye area. “Hyaluronic acid injections plump fine lines and wrinkles, smoothing the overall complexion and adding volume,” Engelman says. “In addition, you will see long term benefits from injectables because dermal fillers build collagen and elastin.”

Under-Eye Filler vs. Botox 

Oftentimes folks who aren’t privy to the world of facial rejuvenation get under-eye filler and Botox mixed up. But, one chat with a dermatologist and you’ll learn that the two are very different things.

“Filler addresses volume loss; Botox addresses crepiness, fine lines, and wrinkles,” Engelman says. “They address different aspects of this anatomical region and often are used together.” She notes that, while Fractionated CO2 and radiofrequency with microneedling can help improve skin texture in the area, when there is hollowing in the tear trough, fillers are best.

How to Prepare for Under-Eye Filler

As with most facial injections, the biggest thing is to lay off any blood-thinning medications. “The most common side effects are bruising and swelling,” Chapas explains. “In order to minimize the risk of bruising we ask patients to avoid medications and supplements that can thin the blood such as aspirin, ibuprofen, naproxen, Vitamin E and fish oil 7 days prior to their appointment,” Engelman adds to this, noting that alcohol can have the same blood-thinning effect, so you may want to skip any virtual happy hours leading up to your injection day.

What to Expect During an Under-Eye Filler Treatment

Under-eye filler appointments aren’t super scary. Chapas says that you can expect a topical anesthetic to start. Once it’s worked its numbing magic for about 15 minutes, the injection will take place. In total, she says that the entire procedure takes anywhere from 15 to 30 minutes depending on the exact under-eye needs of the patient. 

As far as what it feels like, thanks to the numbing, Engelman says that it’s quite manageable. However, she mentions that it’s an unfamiliar sensation of pressure by the orbital bone which can feel odd but not super uncomfortable. 

Lastly, Moran says that she always tells her patients to expect bruising and swelling, just so they’re prepared. “Sometimes it can be pretty noticeable because there are a lot of vessels around the eye and the skin is thin,” she says. “That said, sometimes there is very little bruising.”

Side Effects

As mentioned, bruising and swelling are the biggest things to be concerned about. Chapas says that, if you experience either, it should only last one to two days. Swelling and bruising are common as previously stated. Swelling lasts about 1-2 days. “Patients should avoid positions or exercise where their head is below their waist for 24 hours,” she adds, noting that this will help reduce exacerbating swelling and bruising.  

While extreme bruising isn’t the norm, it is possible. “If there is noticeable bruising, it can be tougher to conceal and may require up to 10 days for some people before they feel comfortable enough to be around people that they would not want to know they had anything done,” Moran says.

To be as transparent as possible (without trying to horrify you in the process), Moran points out that, in rare cases, under-eye filler can cause blindness. “It is extremely rare but it can happen as a result of blockage of one of the vessels that leads to the eye,” she explains. “For this reason, you want to make sure that you only have under-eye filler performed by a licensed medical professional with extensive experience in the use of injectables. If a physician is not performing the treatment, they should be readily available to supervise the treatment. The practice should be in a medical office and they should have hyaluronidase on hand to reverse the filler if there is a problem. Under no circumstances should any filler be used besides hyaluronic acid. The synthetic fillers such as those made up of calcium hydroxylapatite, polymethylmethacrylate, or poly-L-lactic acid should not be used under the eyes.”

Aftercare

Following an under-eye filler treatment, Moran says that it’s best to continue to avoid anything substances that may contribute to bleeding and bruising. What’s more, applying cold compresses to the area several times a day can help with any swelling. And keeping your head elevated can speed up recovery. Easy enough, right?

The Final Takeaway

Under-eye filler is a popular treatment for folks looking to brighten and plump their under-eye area. When performed by a professional (ideally a dermatologist), the treatment is very safe. Apart from freak accidents (like blindness), it’s only when you start seeking cheaper alternatives that things can get dangerous. So, if you’ve been considering under-eye filler, know that it’s a beneficial facial rejuvenation treatment that, when performed with care, can immediately change (and arguably improve) the appearance of your under-eye area. 

Related Stories