Filler for Under Eye Puffiness: Everything You Need to Know

by Linda Robison

Lower eyelid filler can get rid of puffy or hollow eyes and dark circles, but, it's not for everyone. Are you a good candidate? 

A woman getting filler for puffy eyes. Also called tear trough injections.

Filler for under eye puffiness: A great idea, but only if you're the right candidate.

Are you tired of waking up to puffy under-eye bags that make you look exhausted, regardless of how well-rested you are?

Well, there's good news!

Cosmetic fillers can be a game-changer when it comes to combating under-eye puffiness.

But, beware, it's only helpful for certain cases. See if this applies to you.

In this article, we'll explore how it works, what causes this type of puffiness, who should avoid them, potential side effects,and the approximate cost associated with this treatment.

Under-eye filler for eye-bags: What are tear trough fillers and how it works

Tear trough deformity before and after fillers.Before and after injection of tear trough fillers.

Understanding Tear Trough Fillers:

When the inner eye (called a tear trough) area loses volume, it creates a hollow or sunken depression known as tear trough deformity.

This hollowing can sometimes cause a shadow in the inner corners, giving the illusion of bags without actual swelling or fat pads.

Tear trough fillers, usually made of hyaluronic acid, are injected into this area to fill the hollow, restoring volume and reducing the appearance of puffiness.

It's a simple, minimally invasive procedure with temporary results lasting several months to a year.

What causes tear trough hollowing?

Tear trough hollowing can be caused by various factors, including:

A comparison of facial bones between a young woman and older woman.Hollowing of the eye socket with age.

1. Bone structure change: As we age, the shape and structure of facial bones change and shift. Eye sockets become elongate, which can cause a hollowing or depressed appearance. Learn how bone changes can also affect the signs of facial aging.

2. Skin elasticity: As we age, the skin and soft tissues in the under-eye area naturally lose volume and elasticity. This can lead to a sunken or hollow appearance of the tear troughs.

3. Fat and tissue loss: Loss of fat pads and collagen in the under-eye area can result in a loss of volume and create a hollowed appearance.

4. Genetics: Some individuals may be genetically predisposed to having more prominent tear troughs or thinner skin in that area, which can contribute to the hollowing effect.

5. Lifestyle factors: Certain lifestyle habits such as smoking, poor diet, lack of sleep, and excessive sun exposure can accelerate the aging process and contribute to tear trough hollowing.

Tear trough filler for under eye puffiness: Who Should Avoid Them

Tear trough deformity.Tear trough deformity gives the appearance of puffy eyes and dark circles.

According to Dr. Amir Karam, MD, double board-certified facial plastic surgeon specializing in facial rejuvenation, under-eye filler works best to treat classic tear trough deformity, which is characterized by hollowing in the inner corner of the eye.

However, if you have prominent bags or puffiness caused by deposits of fat that extend beyond the inner eye area, malar oedema, festoons, then tear trough filler is not a good choice.

Avoid fillers if:

classic puffy eyeTear trough treatment is not a good option for the puffy eyes due to excess fat deposit.

Tear trough injections are not appropriate for those with:

  • excess fat pads
  • fluid retention or lymphatic problems
  • puffiness that comes and goes
  • thin, loose, or excess skin

Adding filler will only make the puffiness worse because it will draw water to the area.

If excess under-eye fat is the primary cause of puffiness, other treatments may be more appropriate.

These include:

  1. Surgery: Procedures like lower eyelid blepharoplasty or fat repositioning can remove or reposition the excess fat. This option offers a permanent solution for puffiness caused by fat deposits.
  2. Non-invasive procedures: Radiofrequency-based devices or ultrasound treatments can help reduce fat deposits non-surgically. These treatments work by targeting and breaking down the excess fat cells, leading to a reduction in puffiness.

Your doctor can help diagnose the cause of your under-eye puffiness and recommend the best treatment option for you. 

Which filler: Restylane or Juvederm are best for around the eyes.

Both Restylane and Juvéderm are one of the most popular hyaluronic acid (HA) fillers for under-eye treatments.

The choice between the two depends on various factors, including the individual's specific needs, the expertise of the provider, and personal preference.

Restylane and Juvéderm have slightly different formulations and consistencies, with varying gel thickness and durability. 

Some doctors may prefer the smoother texture and spreadability of Restylane, while others may find Juvéderm to be more suitable for their needs.

Ultimately, the decision on which filler is better for under-eye puffiness due to tear trough deformities should be made in consultation with a qualified and experienced professional.

They can evaluate your unique situation, discuss your goals, and recommend the most appropriate filler based on their expertise and your individual needs.

Is it worth getting under eye fillers: Side effects

Many people who had this procedure are extremely happy with the results. It's non-invasive, quick, and results are seen immediately. 

But, it's important that you are the right candidate. A qualified medical professional will be able to determine that.

It's also essential that your injector is skilled and has experience with this type of procedure.

Side effects and complications are possible. They include:

Swelling: Improper tear trough filler placement can cause swelling under the eyes or in the mid-cheek area. This happens if it's injected above the orbicularis retaining ligament or too close to the skin surface, attracting water and causing under-eye swelling.

Note: Tear trough recovery normally involves a degree of swelling as a common side effect of dermal injections.

However, if there is extreme swelling, pain, or it lasts longer than 24–48 hours, it may indicate a problem. Understand the difference and see if your swollen eyes from filler treatment is normal. 

Tyndall Effect: If the wrong filler is used and the particles are large or densely packed, they can scatter light, leading to a bluish tint visible through the skin. This can happen if the injection was placed too superficially.

Over-filling: Excessive tear trough filler can cause puffiness or lumps. When too much filler is used, the area may appear swollen or have noticeable bumps, especially when smiling or viewed from above. 

Darker Eye Circles: Fillers may not be suitable for dark-skinned individuals with dark circle concerns. If your dark circles are caused by darker pigmentation in your skin, fillers could potentially accentuate them.

Necrosis or vision loss: This is very rare, but possible. That's why it's important to find a qualified provider.

How long do under eye fillers last

The duration of results for under-eye fillers can vary depending on several factors, including the type of filler used, individual metabolism, and the area being treated.

However, in general:

1. Hyaluronic acid (HA) fillers, such as Restylane and Juvederm, typically last around 9 to 12 months. 

2. Fillers like Radiesse, which are made from calcium hydroxylapatite, can provide results that last up to 12 to 18 months.

3. Sculptra, a poly-L-lactic acid filler, stimulates collagen production and can offer results that last up to 2 years or more.

Tear trough injections: Cost considerations

Juvederm and Restylane are the most common fillers used around the eyes.

The cost of dermal injection treatments for under-eye puffiness can vary depending on the location, the experience, and reputation of the medical professional, and the amount of filler required.

On average, the cost ranges from $500 to $1,500 per syringe. And, the treatments will need to be repeated around every six -12 months.

Final takeaway: 

Under-eye puffiness can be a frustrating issue, but if it's due to tear trough issues, then cosmetic injections can help.

These volumizing treatments effectively reduce hollows and restore lost volume, resulting in a more youthful and rejuvenated appearance.

You can also consider serums to help temporarily mask the look of puffiness. See results and before and after pictures here to see if this option might work for you.

FAQ: Filler for under eye puffiness

Q: Can Fillers injectables work for dark circles?

A: Yes, it can help. Here is how: 

When the under-eye area loses volume or becomes hollow, it can create a sunken appearance, making the underlying blood vessels and structural elements more noticeable.

HA injectables can fill-in the hollows and reduce the appearance of underlying blood vessels which look like dark eye circles.