Why do dark circles or bags form under the eyes?
Herniated fat pads are hereditary, you were born with it. As we age, the fat is pushed outward from the orbit, also our skin become more thinner and loses its elasticity so the fat is able to appear more prominent. Additionally, we lose medial cheek fat which creates a flatness/depression that we did not have when we were young. All these factors cause the puffiness or dark circles to appear more prominent as we age.
Fillers to the under-eye area are Dr. Lee’s most popular treatment area and most of these patients have never had lower lid surgery. Hollowness to the lower lids/cheeks is a natural progression of aging this is what makes the under-eye filler such a popular procedure. Our filler pricing ranges from $700-$1100 based on product used and provider. add'l syringe based on which product is used. Treatment typically lasts approx. 1 year. If you desire to have filler treatment after lower lids surgery, you will need to wait approx. 2 months to have the treatment performed. **approx. 10% of Dr. Lee’s lower lids surgery patients return for tear trough filler after surgery; most of his lower lids filler patients are not his lower lids surgery patients
How do fillers reduce the appearance of bags and dark circles under the eyes?
Fillers are not appropriate for everyone. Too many providers inject fillers to patients that are not optimal candidates because they do not have any alternative solution that may be more appropriate for them. If a person has visible puffiness due to herniated fat pads and lax skin, filler injections can actually make the lower lids look even puffier. The most popular fillers are HA based and they are hydrophilic- which means they draw in water. Basically, by injecting fillers around fat is like asking for the filler to become puffier over time, thus creating a swollen lower lids/cheeks appearance. People who have noticeable puffiness should consider lower lids transconjunctival blepharoplasty. The procedure takes one hour and Dr. Lee performs the procedure in the office. It’s a permanent solution, once the fat is removed properly- it’s gone! The fat will be gone and will not stretch your skin and you do not have to deal with it again. This procedure is Dr. Lee’s most popular surgical procedure with 99.99% patient satisfaction rate. Filler is ONLY appropriate for people who have hollowness or sunken appearance. Most people as we age lose fat along the cheek area and that is why this procedure is so popular. It is Dr. Lee’s most popular filler treatment but we are very selective on who it’s performed on.
Patient Testimonial
"First, let me start off by saying I NEVER write reviews, however this review is most certainly needed... I’ve been to a few different doctors to have cosmetic work done over the last 8 years (Botox, fillers, etc...) last year was the first time I ever went to Dr. Lee. I did much research because I wanted to have the under eye filler done (which would be my first time having that procedure) Dr. Lee’s work is AMAZING! My under eye was exactly what I’ve always wanted! He also fixed my lips and evened them out - not only is Dr. Lee great, his staff is AMAZING as well (which to me is very important) because they all make you feel so welcome and so comfortable." - Kelly B.
What fillers are used for under the eyes a.k.a. the tear trough?
Restylane is very popular for the lower lids area. However, Dr. Lee feels that Restylane has the highest tendency to create a dark raccoon like result due to the tyndall effect. All fillers can create an appearance of darkness due to the tyndall affect especially if your skin is very thin and light. Fillers are a clear gel like material but the effect is similar to the clear ocean water appearing to be blue due to the reflection of light which makes the water appear dark bluish in color. Volbella and Belotero are popular too but they do not last very long since it’s very thin and watery. Dr. Lee stopped using these products due to patients complaining that it lasted 3-4 months. Dr. Lee has tried every filler out in the market including Vollure and Voluma and he prefers the Versa filler for the lower lids area the most. It has the soft and longevity of Juvederm but less hydrophilic. Sometimes Dr. Lee will use Voluma if the patient has thicker skin.
What Risks and Side effects are there?
Serious risks include blindness and skin death/necrosis if filler is injected into the blood vessels. If filler is injected into the vein, bruising, lumpiness, darkness or shadowing and appearance of even more puffiness can occur if the person has pre-existing herniated fat pads. This is why its important to go with an experienced expert with injectables.
Under Eye Filler Before and After Photos
see our gallery (this is Dr. Lee’s most popular procedure and he has performed thousands of them, a total of 10,000+ eyelids surgeries)
How is a lower lids filler treatment performed?
Most people use a needle and directly penetrate the skin and inject filler to the orbital rim. The filler comes out in little beads or mounds. Then the filler is manipulated and pushed down flat so it does not appear lumpy. The problem is that the lower lids skin is very unforgiving and usually very thin so the slightest lumpiness is very visible. This is one of many reasons why Dr. Lee does not use this method. Dr. Lee has only been treating the lower lids area using the micro-cannula(a very fine, long, blunt needle) technique. The eye area is one of the most vascular area of the entire face/body. There are a lot of blood vessels and no matter how careful one is, pushing a needle into the skin and injecting is dangerous. The needle can easily penetrate the blood vessel and if filler is injected into the vessel, it can cause blindness and skin necrosis(death). Dr. Lee is one of the busiest filler providers in the country and since he performs a lot of filler treatments, he needs to make sure the technique he uses is the safest possible. The cannula method definitely takes more time but Dr. Lee will not perform filler treatments in any area (other than chin and nose) without his cannula. This is the method that Dr. Lee uses to perform his treatment(it’s very different than most):
- Dr. Lee uses the smallest needle available and injects a tiny bit of lidocaine mix to the area that the cannula will be inserted
- A 30 gauge needle is used to prick the skin so there is a hole for the cannula to go in
- Then he inserts a cannula into the skin and then feeds the needle to the tear trough or lower lids area. Then he gently wands the cannula side to side to deliver a very fine amount of filler in a flat/smooth plane. Dr. Lee typically uses a 30mm long fine cannula and penetrates the skin in the cheek area since that area is less vascular. This is why the result is smoother and the transition to the cheek area is more blended in appearance.
What is the cost of under eye fillers?
Our filler pricing ranges from $700-$1100 based on product used and provider. add'l syringe based on provider for one syringe of filler which is typically what is used for this treatment. The treatment usually lasts 9-12 months.
Will I have any recovery after under eye filler treatment?
There isn’t any downtime after our under eye filler sessions at our Bryn Mawr and King of Prussia locations. Both Dr. Lee and Dr. Castelli use a cannula for these under eye filler injections. This requires just a single entry point to reach all areas under the skin. This is different from numerous injections with a standard needle. Because the cannula only needs a single insertion point, there is less risk of bruising, swelling, and vascular issues.
After these filler treatments, patients will have a single purplish dot at the cannula entry point. This will be visible for about one week, but it is easily covered with makeup.
After your session, you can get right back to work or your other normal activities.
Who is a good candidate for under eye filler treatments?
Before Dr. Lee or Dr. Castelli perform these treatments, they first ascertain if you’re right for the procedure. Filler injections do not address puffiness caused by fat pads, dark pigmentation of the skin, or stretched or wrinkled lower eyelid skin. Fillers are only the right approach if the patient has hollowness or a depression in the area, as the filler then returns volume to the sunken areas.
If your problem is volume loss in the under eye area, this could be a perfect answer.
What materials are used in the fillers for these treatments?
Dr. Lee and Dr. Castelli use only hyaluronic acid fillers for these under eye treatments. Hyaluronic acid fillers are categorized as “natural fillers” because hyaluronic acid occurs naturally in the human body (it’s responsible for hydrating, plumping, and firming the skin), so reactions to these fillers are very rare. They provide soft results, as the hyaluronic acid binds with water molecules immediately once injected. And they provide good longevity.
Plus, if there is any problem with the appearance of the area, the effects of hyaluronic acid fillers can be instantly reversed by the injection of an enzyme called hyaluronidase.
How long will my results from under eye filler treatment last?
There isn’t a set timeframe that each person can count on with their results. Dermal filler longevity can vary with the person’s metabolism and even how much they move the muscles in the area the filler is injected. Eventually, the body will absorb the hyaluronic acid and the results will go away. But the tear trough area isn’t a very mobile area of the face, unlike the lips or your forehead, for instance. Because of this, we’ve found results for our patients can last from 12 to 24 months. When the body has absorbed the hyaluronic acid in the filler, your under eye area will appear sunken again. At this point, another treatment will maintain your results.
Are these under eye filler treatments painful?
The molecules in the fillers we use for under eye treatment are smaller than those used in the cheeks, so you don’t feel any pressure once they are injected under the eyes. Pain is only minimal and lasts just a few seconds.
How long will my results from under eye filler treatment last?
There isn’t a set timeframe that each person can count on with their results. Dermal filler longevity can vary with the person’s metabolism and even how much they move the muscles in the area the filler is injected. Eventually, the body will absorb the hyaluronic acid and the results will go away. But the tear trough area isn’t a very mobile area of the face, unlike the lips or your forehead, for instance. Because of this, we’ve found results for our patients can last from 12 to 24 months. When the body has absorbed the hyaluronic acid in the filler, your under eye area will appear sunken again. At this point, another treatment will maintain your results.
What other treatments could be combined with under eye filler injections?
Many of the treatments we offer at Bryn Mawr Facial Aesthetics Center in Bryn Mawr and King of Prussia could be combined with these under eye filler treatments.
If you want to erase your crow’s feet or the 11s between your brows, you could add Botox or Dysport injections to your session. If you’ve had it with your double chin, you could have one of the series of Kybella injections into the jowls to shrink your submental fullness. You could have IPL treatments to eliminate some age spots. You could even have CoolSculpting Elite to get rid of up to 25 percent of unwanted fat on eight areas of the body, such as your abdomen, thighs, or upper arms.
If you’re interested in combining your under eye filler treatment with another treatment we offer, let’s talk about it during your consultation.
Schedule an Under Eye Filler Consultation
To learn more about how Under the Eye Fillers can reduce eye bags or dark circles around the eyes, or to schedule an appointment with a specialist, give us a call today at (610) 789-6701 or fill out an online contact form and our office will be in touch with you. Our practice serves Bryn Mawr, PA and the surrounding areas!
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