Am I a candidate for under-eye fillers? If not, what are my other options? (23F, fair skin, non-smoker) (Photos)

Question

Hello, I recently had a consultation about under-eye fillers and I found it to not be helpful. She basically said "it might work, it might not" so now I'm not sure what to do. I am working on booking a consultation with another clinic to get a second opinion but in the meantime, what do you think is the best option for me based on photos? I feel like when I do the "pinch test" the pigment goes away indicating that it is thin skin and not actual pigmentation. What are your thoughts?

Nima Shemirani, MD · Answer

Hi @lunastellax! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area. If you are hesitant about tear trough fillers, I recommend PRP injections. PRP which stands for Platelet Rich Plasma is a natural and non-surgical solution to treat under eye circles and bags. PRP is highly effective for restoring sunken eyes.  Generally, two vials of blood will be collected from the patient and placed into a centrifuge. The centrifuge spins and separates the platelets from the rest of the blood components. The plasma contains the valuable collagen and growth factors from the rest of the blood's components. The plasma is then drawn up into a syringe and injected in the tear trough area. Typically, 3 sessions is adequate for optimal results.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You would likely benefit from dermal filler injections to reduce the appearance of under-eye bags and lines. These hyaluronic acid (HA) formulas can restore lost volume by adding HA back into the dermal structure. 
Results from dermal fillers typically last for 6-12 months, depending on the formula used. 
I agree that scheduling an in-person consultation with an experienced, board-certified injector for a second opinion is a good idea. They will be able to suggest the best approach to help you achieve your aesthetic goals.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Marc Polacco, MD · Answer

Thank you for your question. Based on your photos, tear trough filler may be helpful in attaining your goals. Now, how much will it help and will it be worth the cost? That's a little tougher to nail down and comes down to your expectations. In addition, treating the under eye region with fillers requires great care and precision, so please seek out an expert if you decide to go through with it. All the best!
-Dr. P

Yao Wang, MD · Answer

Hi there, "dark circles" under the eyes can be caused by a few different factors. Sometimes, the eyelid skin is caused by pigment within the skin, making it appear darker. The way the light hits the nose can also create a shadow. Finally, the skin underneath the eyes are very thin and the muscle underneath is actually darker - which shines through, creating the "dark circles". This is tricky to fix. Because your skin is very thin, filler in this area to help with the hollows may make you swollen. Filler injection should be conservative if you wan to try to see if improves the hollow. Hope this helps.

Peter Andolina, DO · Answer

Based on your photos I think you have a few options when it comes to your under eye treatments. I think filler is a good option but you may also want to consider PRP for that area. PRP is platelet rich plasma and is derived from your own blood. The downside to the PRP is that you may need multiple treatments to see a dramatic result. The upside is that it is all natural and safer to inject seeing as you are just injecting your own plasma into the area as compared to fillers.

Camille Cash, MD · Answer

From your photos it appears that you are a candidate for under eye filler.  It should give you some improvement and smooth the under eye contours.  Visit with an experienced injector to discuss your concerns.  I've included a video that I hope you find helpful.

Center Aesthetic &amp; Dermatology · Answer

You are a candidate to have some improvement with under eye fillers; however there are always limitations. Under eye filler can help with hollowness and shadowing, especially to your lateral (outer) tear trough. Under eye filler however cannot help with hyperpigmentation and vessels. It Also will not take away any bulging from prolapsed fat pads, but it may camouflage them. If you are prone to chronic under eye swelling from allergies, you also may have worsening of swelling. That being said, because you have some hollowness to your tear trough, it appears you would have some improvement with filler. It’s always best to start with minimal amount of product and have realistic expectations!

Am I a candidate for under-eye fillers? If not, what are my other options? (23F, fair skin, non-smoker) (Photos)

Answers (8)

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