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If you’ve tried every full coverage concealer and miracle eye cream at Sephora (often at a serious cost) and are still left with shadows under your eyes that you’d rather weren’t there, then filler may be the solution you’re looking for. Unlike brightening concealers and creams, filler could help tackle undereye hollowness, which is one of the main contributors to dark circles.

However, undereye filler is a highly technical procedure that needs to be carried out by a skilled professional, which is why we got in touch with two world-renowned derms and aestheticians, Dr. Doris Day and Dr. Lily Talakoub. They filled us in (no pun intended) on the amazing in-office treatments that can help to revitalize the under eye, and explained how filler can knock years off (we have pictures!). Here’s everything you need to know.

How Your Eyes Change With Age and How Filler Can Help

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To know if filler is a good remedy for you, it’s important to understand the eye’s natural aging process, and what filler can and cannot address. Dr. Talakoub says, “Not everyone is a candidate. If the undereye circles are due to skin color changes, pigmentation, veins, fat pockets bulging or the skin is too sun-damaged or thin, it may not be the right treatment. I also don’t recommend it if you have a history of recurrent sinus infections because the area can look puffy with a sinus infection.”

“Undereye hollowing is a broad category and includes everything from genetics where it’s the shape of the eyes and the structures around it that creates a natural hollow, to dark circles that look like a hollow without any actual loss of volume in the area, to redness that can also create a shadow-like effect,” says Dr. Day.

Explaining how the eye ages, Dr. Day says that “Deep under the skin is a framework of bone and a socket or hole surrounded by muscles, ligaments, fat pads, lymphatics, nerves and blood vessels that hold everything together under and to the skin.” These elements are crucial, and understanding them is key to rejuvenating this area with aesthetic treatments.

However, Dr. Day notes that these elements don’t age in a synchronous way, which over time, can lead to “hollows, undereye bags, and crepey skin.” Therefore, if you do opt for an in-office treatment, “The aesthetic physician must carefully investigate the source of each issue before treating, and it’s important to understand it often takes a combination of skincare, devices, and sometimes injectables for optimal, natural, and lasting results.”

The Benefits of Undereye Filler 

Both Dr. Day and Dr. Talakoub agree that the easiest ways to resolve undereye hollowness is by using filler, “The best (and really only) way to treat this is to fill the hollowing with a filler. Undereye filler looks the best when the skin over the top of the undereye area is not sun-damaged or extremely thin. I place the filler in the deeper layers of the skin and blend the filler along the entire undereye area so it doesn’t look puffy,” Dr. Talakoub says.

Undereye Filler Techniques

“One technique I use to fix this is to use a cannula (soft needle) to disrupt that ligament, and then I place very small amounts of hyaluronic acid filler to blend the area. I never use a sharp needle to inject this area since the filler can move and it can look lumpy and bluish, which can occur even months after injection,” Dr. Day says. You will feel a minor pinch like plucking an eyebrow hair.

For best results, Dr. Day recommends to go slowly, “You should expect to have more than one treatment with the goal of restoring a normal tear trough rather than over-filling the area. There should be a functional separation of the lower eyelid from the cheek. When the area is overfilled, the lower eyelid becomes one with the cheek and looks unnatural. It also makes the eyes look smaller because the filler can push the lower eyelid up.” You can expect the results to last anywhere between six months to a year.

Below, Dr. Day provides a beautiful example of a natural-looking result with filler: Left is before, and the right is after treatment.

hollow eyesSource: Provided by Dr. Day

 “This beautiful patient in her 30s came in complaining of “bubbling” under the eyes from filler that was injected too superficially. I dissolved the filler to erase the lumps, swelling, and visibility of the original filler and then used small amounts of hyaluronic acid filler with a cannula to restore the area. Amazing how the whole face looks better!”

Why You Need to Find an Expert

As with any facial treatment, finding a highly qualified doctor or plastic surgeon is important, but with the under eyes, there are so many areas to go wrong, that it’s particularly crucial. Dr. Day says, “It’s highly technical, and is a very difficult procedure to perform. We do it very systematically and only for the best candidates. It’s critical to choose someone who has done this procedure often and is an expert. I have performed over two thousand tear trough fillers and I still find it a highly technical and challenging treatment to perform.”

As with all fillers, you also need to consider how it’ll affect your overall facial harmony. By adding to one area, you may also need to consider adding to another. An experienced professional will take this into consideration to guarantee the best results. Dr.Day explains; “It is important to evaluate the midface as well, and it often helps to add volume in specific areas of the midface to improve under the eyes. This is an area for advanced injectors and an area that needs extra-careful consideration to avoid complications.”

Due to the level of expertise this treatment requires, you can expect to pay anywhere between $300 to $800 depending on your location, your doctor, and how much filler you require. As always, when you’re looking for an aesthetician, ask for recommendations, read the reviews, and ask for pictures from previous procedures. And remember, every doctor has their preference for technique.

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How to Determine If You’re a Candidate for Undereye Filler

Before you start looking for an aesthetician, try to find out whether the inflammation or hollowness under your eyes is a result of genetics or lifestyle choices. Dr. Day explains, “A quick test I use in the office is to press on the upper eyelid. If I see a bulge in the lower lid, then I know it’s a fat pad issue. If I don’t see a change it’s more likely to be fluid and, in that case, it helps to control salt intake, and drinking more water helps a lot too. One advancement in our understanding of this area is that there are superficial and deep fat pad and also ligaments. All of which age at different rates. This can cause the fat pads to herniate and creates undereye bags.”

How to Prolong Undereye Ageing

Finally, if there’s one takeaway you need to learn from reading this article, it’s to stop rubbing and touching your under eyes – treat them with care! Dr. Day insists; “The undereye area is one of the most sensitive and delicate areas of the body and it’s often abused. The lower eyelid skin is the thinnest skin on your body. Every day I see women rubbing and aggressively touching their eyes. It hurts to watch! Rubbing creates a defensive response of the skin which leads to thickening, wrinkling and dark circles over time.”

For our top eye creams to reduce dark circles, check out this post.