Draper and Lehi, Utah
Under eye filler is where restraint matters most
Done well it is the most transformative small treatment in the face. Done without a proper assessment it gives you a result that is visible, long lasting and hard to like. Choosing the right candidate is most of the work, and sometimes the honest answer is that it is not you.
Three different problems that look identical in the mirror
- A hollow. Volume loss making a groove that casts a shadow. This is the one that responds well to filler.
- Pigment. Darkness in the skin itself, often genetic or sun related. Filler does nothing for this and can make it more obvious by lifting the surface.
- Protrusion. The fat pad pushing forward, with a groove beneath it. Fill underneath a bulge and you usually get a heavier, puffier lower lid rather than a smoother one.
Most people have some combination of the three. Working out the proportions is what the appointment is for, and for a meaningful number of people the honest outcome is that this is not their treatment. I would rather say that out loud than take the booking.
How it is treated when it is appropriate
Deep, small, and reviewed
Product goes deep, against bone rather than under skin, in small volumes, aiming to do slightly less than the correction looks like it needs. The area keeps settling for weeks, and what looks slightly undercorrected at two weeks is frequently right at six.
Hyaluronic acid only, so it can be dissolved. In an area this unforgiving, being able to undo the work is not a nice extra. It is the reason I will not use anything else here.
Straight answers
Under eye questions, answered straight
Why is under eye filler considered risky?
Two reasons. The skin here is the thinnest on the body, so product placed too superficially shows as a bluish shadow or a visible ridge. And the vascular anatomy in this region carries the most serious complication risk in aesthetics, which is why it should be treated by someone who does it regularly rather than occasionally.
Will it fix my dark circles?
It depends entirely on why they are dark. A shadow cast by a hollow will improve. Pigmentation in the skin itself will not, and thin skin showing the vessels underneath will not either. Plenty of people have a mix of all three, which is why the assessment matters more here than almost anywhere. Individual results vary.
What is the Tyndall effect?
A bluish gray tint that appears when filler sits too superficially under thin skin and scatters light. It is the classic tell of under eye filler placed at the wrong depth, and it is one of the reasons this area rewards restraint and the correct plane far more than volume.
How long does it last here?
Often considerably longer than elsewhere, sometimes well beyond a year, because the area moves relatively little. That cuts both ways. A good result lasts, and so does a poor one, which is another argument for treating conservatively.
Who should not have this treatment?
People whose main issue is fat pad protrusion rather than hollowing, people with significant fluid retention or puffiness that varies through the day, and people with very lax lower lid skin. In all three, filler tends to make things heavier rather than fresher. There is a real surgical answer for some of these and I would rather point you at it than hand you a syringe.
Read first
Before you book
Lip filler migration: what it actually is
Four different problems share one word. The rate you have been quoted is not an incidence, and what ultrasound shows points at depth rather than volume.
Do I need Botox or filler?
One relaxes muscle, the other adds structure. A thirty second test in a mirror usually tells you which problem you have.
How long does lip filler last?
Lips break filler down faster than anywhere else in the face, and what looks like long lasting product is often something else entirely.
Find out whether you are a candidate
An assessment here is worth having even if the answer is no. Especially if the answer is no.