Under eye filler, not pleased with results. What else should I try? (Photo)

Question

I had under eye filler placed, Belotero specifically but it appears to look like a dark hue in certain lighting. I have had it reversed with hyaluronidase and refilled but it is giving the same result. People always tell me I look tired. Any advice? I feel like it looked like this after it was dissolved as well. Will it permanently be this way? Should I try a different filler or a laser instead? Thanks!!

Tanya T. Khan, MD · Answer

Hi, it is difficult to tell from the photo, but not clear that there is a huge volume deficit to fill in the first place (not sure if the photo is before or after hyaluronidase). In either case, you should really be evaluated by an oculoplastic surgeon regarding your eye area since you may not even be a candidate for filler. It is possible that the filler was injected too superficially giving a strange surface hue and Belotero is not the best choice under the eyes anyway. You may also investigate laser resurfacing / micro needling / chemical peels and potentially even surgery.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience and your concerns so openly. What you’re describing is something I hear from many patients who have undergone under-eye filler, and it can understandably be very frustrating. The under-eye area is delicate, and sometimes even with careful placement, fillers can create a shadowy or bluish hue (often called the Tyndall effect) that shows up more in certain lighting.

When hyaluronidase is used to dissolve filler, it can improve the appearance, but in some cases, the skin may still look thinner or slightly hollowed afterward, which can make shadows more noticeable. This doesn’t mean the changes are permanent, but the skin under the eyes is naturally thin and can sometimes make any irregularity more visible.

Options that may help include:

Trying a different type of filler with a different texture or placement technique, though results can vary from person to person.

Energy-based treatments or lasers that focus on tightening the skin and improving pigmentation or texture in the under-eye area.

Topical treatments and medical-grade skincare to improve skin quality and brightness, sometimes in combination with procedures.

It’s important to know that what you’re experiencing isn’t uncommon, and it doesn’t mean that you’re “stuck” with this look permanently. With the right approach tailored to your specific anatomy, there are ways to soften that tired appearance and restore a fresher look.

A.J. Amadi, MD · Answer

If you feel that there is a shadow or pocketing under your eyes, your injector may be putting that filler too superficially and Belotero is an hyaluronic acid based filler meaning it pulls in water so it may be giving you that “puffy” tired look.  I would consider trying another filler and exploring those options if you are trying to target hollowness or give more brightness for the under eyes	ear troughs. There are some products that are specifically made for tear troughs and it looks like Belotero is on label for different areas of the face and not specific to the tear troughs.

Stefan Weiss, MD · Answer

It may be have been placed too superficially giving a tyndall effect. However, if was like that when the filler was dissolved it may not be an issue of undereye hallows. Sometimes laser can tighten the skin and provide a better long term outcome.

Leonard Grossman, MD · Answer

I have been using hyaluronic acid fillers for over 30 years, and I know enough that sooner or later, all individuals who have a hyaluronic acid filler placed in the trough will have an issue: one is the bag and two is the puffiness that radiates a blue hue.
Dissolving all of the filler in small increments using hyaluronidase, then replacing it with your own fat. In the right hands, fat grafting produces natural and practically permanent results. I hope this helps and good luck from Leonard Grossman, M.D., organic Plastic Surgery, New York City.

Darryl J. Blinski, MD · Answer

Based on only 1 posted photo appears you are NOT tired appearing??? But might try Endo Laser to lower lids temple areas. Fee $3,500. Best yo virtual consult with …..

Under eye filler, not pleased with results. What else should I try? (Photo)

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