Under Eye Filler: The Double-Edged Sword

Under Eye Filler: The Double-Edged Sword

The Natural Plastic Surgeon Blog

“The eyes are the windows to the soul,” is an adage that has been repeated throughout history, and for a good reason. Your eyes are very likely the first thing others notice about you. That’s why it’s so important to keep them looking youthful—a task that becomes increasingly more difficult as we age.

Though the reasons for the effect are varied, the term “under-eye bags” is used to refer to mild swelling, saggy or loose skin around the eyes and even dark circles. No matter which of these symptoms plague you, Barrett Plastic Surgery has a combination of correction techniques that will refresh and rejuvenate your appearance, including the most popular choice: under-eye fillers. Perhaps more than any other cosmetic procedure, choosing the right doctor to perform your under-eye treatment is of the utmost importance. This is not the time to use a Groupon.

“It’s critical that this area is treated with a comprehensive approach by an incredibly skilled practitioner—I’ve seen some nightmare results in patients who didn’t do their research. And it’s incredibly hard to fix if the procedure is done incorrectly.”

Dr. Barrett

Here’s everything you need to know about under-eye fillers and how to get precisely the results you seek.

Causes of Under-Eye Bags

As we get older, the tissues and muscles around our eyes weaken. The fat that previously helped to support the eyes moves into the lower eyelids, causing the lids to appear puffy. Fluid can also accumulate in this area, adding to the swollen effect.

Furthermore, extreme fatigue, dehydration and genetics can all make the skin under the eyes look sunken and appear more translucent, allowing for the dark tissue underneath to show through. In still other instances, allergies and eye strain—from looking at a computer screen all day, for example—can cause blood vessels to dilate and become more visible.

Even overexposure to the sun can cause pigmentation in the skin surrounding the eyes to darken in people with certain skin tones. Just as the term under-eye bags refers to many different symptoms, what causes them is equally varied. One size does not fit all when it comes to treating under-eye bags either! Dermal fillers are only one piece of the under-eye correction puzzle.

Potential Complications to Treatment

In the U.S., dermal filler treatments have increased dramatically in the last few years, and, therefore, not everyone performing them has enough expertise. In addition to traditional cosmetic specialists, doctors with less-extensive experience—like dentists, allergists and gynecologists—are also using dermal fillers. Physician’s assistants, nurse practitioners and medical estheticians may also be involved in injecting fillers into the face. We’ve heard horror stories of people getting injections in someone’s kitchen, the back of a nail salon, or a “MedSpa” with no doctor on site.

The problem is, people without in-depth knowledge of facial anatomy can create irregular results—especially in the eyelid region—because the skin is so thin it shows everything. Filler, in qualified hands, has to be injected into multiple levels to get the kind of correction needed to provide a refreshed result. Botched jobs run the gamut from using too much filler (effectively taking the eyes from “sunken” to “puffy”) to the tyndall effect when eyes appear more grey or darker then when you started. Even more importantly, the eye area is a filler danger zone. A good provider will also know to steer clear of your veins in this very vein-rich area to prevent horrific side effects like filler blindness.

No matter who you choose to perform your treatment, you’ll want to ensure they are board-certified and experienced in injecting the under-eye area. This means that your injector has a superior understanding of the anatomy of the area, the risks of the procedure, and has been properly trained in how to create a natural result.

Are Dermal Fillers Right for You?

Dermal fillers are one of Dr. Barrett’s most popular options for replacing lost volume and helping to combat dark circles. These injectable treatments of hyaluronic acid stimulate the appearance of thicker fat pads under the skin. Hyaluronic acid is found in the skin’s dermis but starts to diminish over time. In filler, it helps pull water for additional plumping power, so it creates a natural look that lasts many months.

Hyaluronic acid filler under the eyes must be used sparingly. Deeper filling of the surrounding cheeks may also need to be performed to boost the area so less is actually needed under the eyes. This is typically done with a different filler that uses calcium hydroxyapatite and has the highest lifting factor. Here again, working with a certified professional is critical, as filler is only one piece of the puzzle and you may need a combination of treatments for the best possible results.

Other Treatments for Under-eye Bags

Another opportunity for error is in the type of procedure used to correct the under-eye bags. For example, dark circles can be caused by discoloration or an indent. If the shadows under your eyes are a result of hyperpigmentation or a reflection of blood or muscle, filler isn’t the right solution, and you need a doctor who understands the difference.

In some cases, doctors will address the appearance of bulging fat around the eyes with surgery to remove and/or reposition the fat around the eyes. Not only does this require a thorough knowledge of the anatomy of the eye region, but Dr. Barrett believes for a good number of his patients, surgery is not the answer. Instead, he typically recommends a minimally-invasive combination of procedures like fillers, skin resurfacing and pigment treatments. Read on to learn more about some of the other treatments and what they can do for you:


Since dark circles can often be attributed to collagen loss in the dermal structure, microneedling (also known as collagen-induction therapy) can be helpful because it restores collagen levels to reverse the signs of aging. The procedure creates micro-channels in the skin to trick your dermis into producing more collagen and stimulating cell renewal. Positive results appear gradually and look completely natural.


This laser treatment is a safe, non-invasive procedure that helps rebuild the dermal structure and rejuvenate the skin. The fractional technology works similarly to microneedling, creating micro-channels in the skin that trigger the body to produce more collagen. The device is designed to target small areas of skin, leaving the surrounding dermis and tissue untouched for rapid healing, and can be precisely adjusted to accommodate the exact amount of correction you require.

All of these procedures are performed right in our office, and a topical numbing cream can be applied to minimize discomfort. In most cases, the appointment will take less than an hour, and there is little to no downtime afterward.

Are you interested in under eye filler? Call us at (310) 398-2648 or fill out this virtual consultation form and we will reach out to you as soon as possible. We’re excited for you to take this next step!

contact us

Are you ready to take the next step?

Dr Barrett Plastic Surgery in Beverly Hills

Start your journey now with a virtual consultation. Have more questions? Fill out the contact form below, and a patient care representative will reach out to you shortly. We look forward to hearing from you!

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Dr Barrett Plastic Surgery in Beverly Hills