Under-Eye Filler

Three different things get described as "dark circles," and only one of them responds to filler.

Hollowing is a structural shadow. The orbital rim becomes visible as the fat pad above it descends and thins, and the resulting depression casts a shadow that reads as darkness. Press gently on the area — if the darkness lifts when the hollow is filled by your fingertip, you have a volume problem, and filler is the right tool.

Pigmentation is melanin in the skin itself, common in deeper skin tones and often hereditary. Filler does nothing for it and can occasionally make it look worse by pushing pigmented skin forward. Vascularity — visible blue-purple vessels through thin skin — likewise does not respond to filler and is better addressed with skin treatments. Many people have a combination, in which case filler treats only their hollowing component and we say so before you book.

The skin under the eye is the thinnest on the body, there is minimal subcutaneous fat to camouflage product, and the tear trough sits directly over the infraorbital foramen and the angular vessels. Errors that would be invisible in a cheek are plainly visible here.

The two characteristic complications are the Tyndall effect — hyaluronic acid placed too superficially scattering light and creating a bluish-grey cast — and prolonged puffiness from product placed in a poorly draining plane or from an over-hydrating product drawing water in.

Both are largely technique-dependent. Product belongs deep, on the periosteum, in small aliquots, using a low-hydrophilicity, low-lift filler and typically a cannula. We deliberately under-correct and reassess at two weeks rather than chase a complete correction in one sitting.

A meaningful proportion of people who ask for under-eye filler get a better outcome from mid-face support instead. The tear trough deepens partly because the cheek fat pad below it has descended; restoring that pad lifts the whole complex and softens the hollow without putting anything in the highest-risk zone on the face.

If your consultation concludes that treating your cheeks will fix your under-eyes, that is a better plan, not a bait-and-switch. It is lower risk, usually looks more natural, and often lasts longer.

Under-eye filler is $850 per syringe at Plump, $765 for members. Most patients use well under a full syringe across both sides — this area takes remarkably little product, and a full syringe placed under two eyes would be substantially over-treated.

It typically lasts 12-18 months because the area moves relatively little. Swelling and bruising are both common in the first week; the skin is thin and the vessels are close to the surface, so plan around any event by at least two weeks.

It is fully reversible with hyaluronidase, which is a meaningful reassurance in an area where the margin for error is small.