Fillers such as Radiesse are meant to replace areas of lost tissue. They are therefore used for wrinkles, depressions, hollows, dents and so forth. Under the eyes you can use fillers like Perlane, Radiesse or Fat transfer to fill in what are known as tear troughs. Tear troughs are the depressions or shadows that occur just along the junction of the lower eyelid and the cheek. These can be filled or plumped to create a smooth contour of the lower eyelid.
Eyelid "bags" are different. This is a phenomenon created by fat pads pushing through the skin to form bulges in the lower eyelids. These bulges need to be removed surgically. The surgery is usually performed through an incision on the inside of the eyelid with no visible scars and can be combined with laser resurfacing to help tighten the eyelid skin and create a smooth finish. If a depression or tear trough also exists, then the fat can be repositioned or moved into this hollow area to plump where it needs to be plumped.
So when you look in the mirror, ask yourself if there are bags that protrude or hollows that create shadows or both and then you can decide what is the best procedure. The objective is to remove extra bulk and plump area that are depressed to create a smooth contour from eyelid to cheek. Your cosmetic surgeon will help you decide what procedure(s) are best suited for your needs.
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