{"id":20215,"date":"2021-07-08T12:12:34","date_gmt":"2021-07-08T19:12:34","guid":{"rendered":"https://www.realself.com\/news\/?p=20215"},"modified":"2023-10-12T16:50:35","modified_gmt":"2023-10-12T23:50:35","slug":"under-eye-filler-vs-prp-dark-circles","status":"publish","type":"post","link":"https://www.realself.com\/news\/under-eye-filler-vs-prp-dark-circles","title":{"rendered":"Under-Eye Filler vs. PRP Injections for Dark Circles: Which Is Right for You?"},"content":{"rendered":"

Under-eye filler<\/a> has earned a curious reputation for being both a top shot in injectors’ offices and, we’re told, the most problematic of procedures. In recent months, several practitioners<\/a> have taken to social media, cautioning against using certain fillers<\/a> in the delicate tear trough area and highlighting how smart placement, technique, and patient selection<\/a> can help stave off complications, both in the short-term and down the line. (Tear trough filler, we should note, is an off-label treatment, as no injectable gel is currently approved for the area.)<\/p>

“The under-eye region is complex and one of the more difficult places to treat on the face, for finessed results,” says Dr. Amelia K. Hausauer<\/a>, a board-certified dermatologist in Campbell, California. Various factors contribute to the trickiness of the tear troughs, including the quality and substantiveness of the tissues under the eyes. Not only is the skin the thinnest on the body, but fat is also in short supply here; taken together, these make the area highly unforgiving. “There’s less tissue to cover the filler, so bumps, swelling, and a blue discoloration from gel placed too high in the skin, termed the Tyndall effect, are more common,” Dr. Hausauer explains. Moreover, whatever fat does exist in the region tends to droop and bulge, forming bags, which are challenging to camouflage with filler, especially if your skin lacks snap.<\/p>

Sitting just beneath the skin of the lower eyelids is a lymphatic system, charged with clearing fluids and promoting immune function. If clogged and incapacited by poorly placed filler, pockets of puffiness can form<\/a>, waxing and waning over time (at least until the filler is dissolved). Hyaluronic acid (HA) gels also attract and hold water, some more efficiently than others, and can be slow to break down in the tear trough region, so if an inappropriate product is used, the under-eyes can look bloated and boggy for years after injection<\/a>. <\/p>

Given the intricate anatomy of the tear troughs and potential for trouble, “only 30% of patients who come in requesting under-eye filler end up having that treatment, due to candidacy,” notes Dr. Flora Levin<\/a>, a board-certified oculoplastic surgeon in Westport, Connecticut. She also dissolves a lot of tear trough filler that should never have been injected in the first place. <\/p>

As injectors grow increasingly wise to which dark circles truly qualify for filler, some are offering blood-derived platelet-rich plasma (PRP) injections<\/a> as an alternative for select patients. While the evidence supporting PRP’s efficacy under the eyes, specifically, is somewhat limited, the growth-factor-rich product has been shown to stimulate collagen production for thicker, smoother skin—making it a promising remedy for tired under-eyes.<\/p>

Ahead, experts explain who can actually benefit from tear trough filler; when PRP may be a better option; and which under-eye issues demand a different treatment altogether.<\/p>

Who is—and isn’t—a candidate for tear-trough filler?<\/h2>

“Patients with hollowness, excellent skin tone, and minimal to no under-eye bags are the best candidates,” Dr. Levin tells us. For those whose dark circles are a direct result of volume loss—meaning there’s an actual depression where the lower lid meets the cheek—a small amount of HA gel can be injected deep, under the skin and muscle, she says, to level the topography of the area and obviate shadows in the most seamless way possible. “Injectors must have a very good understanding of anatomy, to reach the appropriate level of injection known to avoid complications,” adds Dr. Hausauer. <\/p>

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A post shared by Dr. Flora Levin (@floralevinmd)<\/a><\/p><\/div><\/blockquote>