Under Eye Filler - Procedure, Pros, Cons & Costs

Under-eye fillers are a standard procedure in dermatology and cosmetic surgery. About 2.6 million people get dermal fillers each year to prevent signs of aging, add volume, or improve skin texture.

Many licensed healthcare professionals also use under-eye filler treatments as an off-label cosmetic procedure to reduce wrinkles, fine lines, and dark circles. 

How Does Under-Eye Filler Work?

As we age, our skin loses elasticity, volume, and moisture. Under-eye dermal fillers are gel-like substances injected into the skin. 

They contain natural substances already found in soft skin tissue and work by attracting water while locking in moisture. This creates volume and provides structural support.

However, dermal fillers are temporary because they are reabsorbed by the body. After a couple of months, they lose their initial effect. 

Fortunately, you can repeat the procedure when the effect subsides. The most common and effective substances found in under-the-eye fillers include:

• Hyaluronic acid. A sugar naturally found in human and animal tissue.
• Calcium hydroxylapatite. A mineral essential for bone function.
• Poly-L-lactic acid (PLLA). A biodegradable, synthetic material that stimulates collagen production.
• Autologous fat transfer. Uses fat grafting to restore volume.
• Polymethylmethacrylate (PMMA). Contains cow collagen and is not reabsorbed by the body.

What are the Benefits of Dermal Fillers?

In addition to improving eye hollows, dermal fillers are approved to:

• Correct moderate to severe facial wrinkles and skin folds
• Increase fullness of lips, chin, the cheek area, and the backs of hands
• Restore fat loss for people with HIV
• Correct cheek acne scars

Is Under-Eye Filler Safe?

Overall, hyaluronic acid fillers are safe to use under the eye. Studies have shown that tear trough treatments using hyaluronic acid are safe, painless, and highly patient-satisfaction-rated.

However, like all medical procedures, dermal fillers come with risks and possible complications, including:

• Lack of symmetry between the eyes
• Overcorrection
• Undercorrection 
• Blue or puffy appearance (Tyndall effect)
• Persistent inflammation
• Allergic reaction 
• Damage to blood vessels causing blood flow blockage
• Central retinal artery occlusion (CRAO), which leads to permanent blindness
• Skin infection

Since the tear trough (under the eye area) is sensitive and delicate, the U.S. Food and Drug Administration (FDA) has only approved JUVÉDERM® VOLBELLA® XC for under-the-eye filler treatment in adults over the age of 21.

What are the Pros and Cons of Under Eye Filler?

The decision to get under-eye fillers is personal. Before getting under eye fillers, you should discuss the risks and benefits with a licensed healthcare professional.

Let’s explore the pros and cons of under-eye dermal fillers:

Pros	Cons
It can be natural-looking, corrects under-eye circles and hollow appearance, and helps prevent signs of aging (wrinkles, fine lines, sagging skin)	It only lasts 4 to 12 months and slows natural hyaluronic acid production
Immediate results, easy to smooth out during treatment, can be reversed using hyaluronidase	Possible swelling or bruising. Without proper technique, it can risk infection and deformity
Absorbed by the body	Expensive, usually not covered by insurance

Is Under-Eye Filler Better Than Botox?

Many people might think of Botox when they hear under-eye filler, but they are not the same thing. While dermal fillers increase volume and plumpness, Botox improves the appearance of fine lines and wrinkles. 

Botox is not a dermal filler and is only used on areas of the face that have muscle movement (which aids in facial expressions). The FDA refers to Botox as an injectable drug that keeps muscles from tightening, resulting in less visible facial wrinkles.

Other uses for Botox include improving:

• Crow’s feet 
• Frown lines 
• Forehead lines 
• Chronic migraine
• Overactive bladder
• Spasticity 
• Excessive underarm sweating

The FDA hasn’t approved using dermal fillers in combination with Botox. However, studies have shown that using both Botox and dermal fillers containing hyaluronic acid and calcium hydroxylapatite had the best facial enhancement results.

How Much Do Under Eye Fillers Cost?

On average, under-eye filler treatments cost between $600 and $2,000 per session. Most people require one to two syringes per treatment, bringing the total cost to roughly $1,000 to $3,000.

The cost of under-eye fillers can vary significantly based on several factors:

• Type of filler. Different brands and formulations have varying price points.
• Amount of filler. The number of syringes needed depends on the severity of your under-eye concerns.
• Provider's expertise. Highly experienced injectors often charge more for their services. 
• Geographic location. Prices can differ based on the region and the local market.

Some medical practices offer financing options or payment plans to make under-eye filler treatments more accessible.

During your consultation, we suggest asking for a detailed breakdown of the costs involved, including the price per syringe, the estimated number of syringes needed, and any additional fees.

Long-Term Costs for Maintenance

Under-eye fillers generally last between 12 to 18 months, though this can vary based on individual metabolism and the specific product used.

Additionally, you may need to go through maintenance treatments to sustain results over time.

Fortunately, you can prolong its effects by adopting a healthy lifestyle, using sunblock, and using high-quality skin care products.

What to Expect During an Under Eye Filler Procedure

Right before the procedure, the licensed professional will mark the location of the treatment area and clean it. A topical anesthetic numbing cream will be applied to the treatment area before the injection to minimize pain and discomfort. 

These are the steps of under-eye filler treatment:

1. The provider will strategically inject gel filler into the deep tear troughs under the eyes with either a needle or a blunt-edged cannula.
2. You may feel a burning or stinging sensation during the procedure.
3. The provider will smooth the filler into place.
4. You should see immediate results with a hyaluronic acid filler.

One or more injections may be needed depending on treatment goals.

What is Under Eye Filler Aftercare Like?

After the eye filler procedure, you can typically return to normal activities immediately. They may have you ice the treatment area for 15 to 20 minutes before leaving to reduce redness and swelling.

Your provider may recommend the following aftercare instructions:

• Refrain from strenuous activity for 1 to 2 days
• Avoid sleeping face down
• Periodically apply ice for the first 24 to 48 hours after treatment
• You can smooth out any lumpiness with your finger
• Stay out of the sun and avoid using tanning beds