Why Didn't The Filler for Under Eye Hollows Do the Job?

Filler under the eyes doesn't always work. It depends on your anatomy and the cause for the dark circles. The best candidates are people with small bags, then a dent called a tear trough then a cheek mound. Hll-valley-hill. The valley between the two hills is filler with filler such as Restylane. If you just have hollow eyes, filler may not always do the trick. You can't always treat certain shapes of facial anatomy by adding injection of a gel. Sometimes it may just be a matter of using less or doing it in stages.

           Restylane to the tear troughs is probably as good a treatment option as is available. You may need more product placed at a different depth or a different locale to balance the appearance.   You may need some of the material present dissolved prior to proceeding further.  All of this could be determined during the exam. 

Kenneth Hughes, MD Los Angeles, CA

Photos would really be necessary to provide you with the best advice. In general, there are numerous causes for dark circles under the eyes which may include the following:  pigmentation irregularities, sun exposure, visible blood vessels, stress, allergies, atopic dermatitis, pseudoherniation (outpouching) of fat from the eyelid, and heredity, to name a few.  Fat can cause the appearance of dark circles, which can be corrected by fat repositioning blepharoplasty.  As individuals age, skin tends to thin and the normal fat pads in the eyelids herniate from their normal positions and become more prominent.  This prominence can appear as bags under the eyes, and the shadow they cast appear as dark circles, while the thinner skin causes blood vessels to be more noticeable, contributing further to the dark hue.  Some pigment can be treated with laser and/or bleaching creams.  However, if it is too deep the treatment will not be effective.  In general, Restylane injections for the tear trough require an experienced professional. If you are not happy with the way the Restylane looks, it can be dissolved with the enzyme hyaluronidase. I would recommend communicating your concerns to your physician, as they will be able to help you determine the next step. Thank you, and I hope this helps.