{"id":21229,"date":"2021-11-16T11:42:33","date_gmt":"2021-11-16T19:42:33","guid":{"rendered":"https://www.realself.com\/news\/?p=21229"},"modified":"2023-10-17T15:43:23","modified_gmt":"2023-10-17T22:43:23","slug":"under-eye-filler-alternatives","status":"publish","type":"post","link":"https://www.realself.com\/news\/under-eye-filler-alternatives","title":{"rendered":"Under-Eye Filler Isn\u2019t For Everyone. Top Oculoplastic Surgeons Share Their 3 Favorite Alternatives."},"content":{"rendered":"

Despite its ubiquity across social media, hyaluronic acid (HA) filler<\/a> isn’t a panacea for tired or aging eyes. “In fact, only very select patients are good candidates—those with true hollowness, nonexistent or very small under-eye bags, no issues with fluid retention, and good eyelid skin,” explains Dr. Flora Levin<\/a>, a board-certified oculoplastic surgeon in Westport, Connecticut. Anyone who doesn’t meet these criteria—i.e., most adult mortals—will likely see subpar results or complications from tear-trough filler, according to Dr. Levin. <\/p>

The “good eyelid skin” prerequisite—meaning taut, firm lower lids—tends to limit top contenders to those in their 20s and 30s, points out Dr. Mitesh Kapadia<\/a>, a board-certified oculoplastic surgeon in Boston. “Older patients with some skin laxity can occasionally be treated with fillers,” he says, “but it takes a lot more experience to give them a nice result.” <\/p>

Even if you do qualify for tear-trough treatment—and have a genius injector—you can’t count on filler to solve your every issue. In the under-eye area especially, “fillers have real limitations,” says Dr. Christopher Zoumalan<\/a>, a board-certified oculoplastic surgeon in Beverly Hills, California. “They don’t help with skin texture, crepiness, dynamic crow’s-feet, or discoloration”—be it melanin-related or vascular in nature. <\/p>

Dr. Zoumalan also warns that, in most cases, attempting to veil or blend under-eye bags—aka herniated fat pads—with filler is a setup for side effects, including persistent puffiness, a lumpy or uneven result, and a bluish tinge. Adds Dr. Kapadia, “When you try to camouflage significant bags, it may look okay immediately after treatment, but it’ll often appear odd and unnatural with time.” Only a blepharoplasty<\/a> can eliminate bulging bags—but, of course, eyelid surgery alone can’t correct hyperpigmentation or wrinkling, which is why it’s so frequently paired with nonsurgical treatments like lasers, peels, and the like.<\/p>

The moral of the story? Under-eye filler isn’t for everyone. If a trusted injector refuses to fill you, thank them for sparing you future headaches and move on to a more suitable treatment. Ahead, experts share the best filler-free solutions for common eye-area concerns.<\/p>

For fine lines and crepey skin: CO2 laser or microneedling <\/h2>

While Botox<\/a> can help keep crow’s-feet and under-eye crinkles from forming or deepening, it rarely eradicates them completely. Smoothing those etched-in lines generally means jump-starting the body’s healing response, to kick up collagen production for plumper skin. While there are various ways to do this, the oculoplastic surgeons we spoke to lean toward fractionated CO2 lasers<\/a> for fairer skin tones and some form of microneedling<\/a> for darker complexions or anyone aiming for less downtime. <\/p>

“The CO2 is an ablative laser that creates microscopic columns in the epidermis,” explains Dr. Tanya Khan<\/a>, a board-certified oculoplastic surgeon in Austin, Texas. “As this topmost layer of skin sloughs off in the post-treatment period, the body is forced to produce its own collagen and elastin, to repair the columns created by the laser. As such, the CO2 laser will simultaneously help with both erasing superficial areas of discoloration and reducing crepey skin by thickening the skin itself.”<\/p>

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When reaching for the CO2, Dr. Khan first preps the skin with numbing cream for about an hour and shields the eyeballs with both “bandage contact lenses”—prescription-free lenses of a standard size—as well as a special “metal plate that goes over the eyeball and under the eyelid, to help tent the skin for better exposure of [its] surface and to protect from stray laser radiation,” she says. For the first week or so after CO2 treatment, patients typically look red, swollen, and scabby—aftercare involves disinfectant vinegar soaks plus occlusive ointments—but impressive results can be seen fairly quickly, usually by 10 to 14 days out.<\/p>

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A post shared by Dr. Brian Biesman (@drbiesman)<\/a><\/p><\/div><\/blockquote>