Radiesse should not be used under a thin cover.
What we call bags under the eyes become more apparent with age due to increasing looseness of the eyelid skin and muscle. This laxity makes the normal fatty tissue around the eye more prominent. More importantly the area under the "bag" becomes deep forming a depression or a trough. This area, commonly referred to tear trough, accentuates the prominence of the bag. The idea behind using a filler material in this area is to make the cheek and the lower eyelid area more continuous and even in contour so that the bag becomes less obvious.
The tear trough is an area of bone covered with a thin muscle layer and an even thinner layer of skin without much fat. It is very difficult to lay a thick material like Radiesse in this area and not make it lumpy or visible. Even thinner material like Restylane should be used very cautiously placing only small amounts in the deep. If the tear trough area is extremely thin, a filler shoud not be used at all.
