Am I a candidate for filler under eyes? (photo)

I went to a nurse practitioner at a dermatologist yesterday to see about a filler for under eye. I do have a fat pad, esp under one eye. She said it would bulge and be swollen, that I don't have the right anatomy. Any thoughts? Also pricing if I am, just a range? Thank you :) I don't want to do surgery.

Doctor Answers 9

Eye bags

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.


New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

Lower eyelid bag

Thank you for your question.  Looking at your photos, a lower eyelid blepharopalsty would be my first recommendation to eliminate the bag.  However, if you are opposed to surgery, then filler to the lower lids combined with a laser resurfacing of the eyelid skin would give you a nice improvement.  In my experience, patients that really do not want to undergo surgery, are happy with this alternative option.

Jessica Lattman, MD
New York Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Large bags under the eyes

 Thank you for sharing your question. Unfortunately, the only treatment that will correct your problem is lower eyelid blepharoplasty. See an experienced oculoplastic surgeon in person for comprehensive evaluation and discussion of potential treatment options. Good luck, 

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Not ideal

So the thing that is most notable about your eyes is the sagging fat pads. This comes from an ageing orbital septum. The best treatment for this is surgery or if mild, laser resurfacing or tightening.

Fillers can hide the lid cheek junction but they will not help your sagging lower lids and in fact may make them worse.

Hope that helps.

Adam Goodwin

Am I a candidate for filler under eyes?

Not everyone is a good candidate for fillers in the tear troughs but you may have some improvement based on the pictures. See link below for examples. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

Under eye treatment

You would see some improvement with filler under the eye.  In your situation it is probably best if you combined procedures.  You can consider laser treatments or microneedling (Skin Pen) in addition to the filler for a more complete result.  For a more permanent change, a lower blepharoplasty surgery could be an option.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Under Eye Rejuvenation with fillers, lasers, microneedling/prp, radiofrequency

A combination approach would be best. I recommend a combination with lasers, microneedling/prp, radiofrequency and well-placed fillers. Cost will vary. See a cosmetic dermatologist for a formal evaluation. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Filler candidate for eye bags

You have a combination of bulging under-eye fat pads and a depression below termed the tear trough.  Fillers such as Restylane would help to lessen the appearance of the bag and reduce the hollow area, making you look less tired.  This nonsurgical approach would give you a partial but not a full correction.  

Surgery would provide a more complete improvement and this involves shifting of your bulging fat into the hollow area from behind the eyelid.

See my link below with an infographic describing the pros and cons of filler vs. surgery for eye bags. 

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Eye bags

Eyebags are difficult to treat. You are right that bags are not best treated with fillers. 

The bags are formed when tissue from the orbit hangs and bulges over the nasojugular ligament. We can augment and slightly lift this ligament with fillers. I use a cannula to slide it under the ligament that can help blunt this transition point. I just uploaded some pre and post fillers for eyebags. The best way to treat it is a lower lid bleph with fat repositioning as that treats the real cause. Fillers can help though if done in the right hands.

Hope this helps.

Best of luck,

DrC

Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.