How much filler would I need per eye to treat my tear troughs? (Photos)

Question

I'm 27 and have had dark circles which have bothered me for almost 2 year now (made worse after birth of my daughter), no creams have aided this and I have seen no improvement using expensive as well as cheap eye creams. I've decided to book a consultation for tear trough filler. I am wondering how much filler i will need for each eye.

Munir Somji, BSc, MBBS · Answer

I only recommend maximum 1ml spread under both eyes for one sitting. This is because overfilling the tear trough area can lead to complications afterwards. My general protocol is to wait 2 months after the first session to see if patients need more. Without examination it will be difficult to tell how much you need as there are many variables. What you must make sure is that you go to someone who is qualified to perform this procedure. This is sadly rarely the case in the U.K.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question maivson23. I understand your concern. Fillers are used to
restore lost volume in and enhance the appearance of the face. In the tear troughs I usually start with 1 cc of filler. The results are assessed 2 weeks later once swelling has subsided. At that point more product can be added if further enhancement is desired. Please
consult with a doctor for specific recommendations.  Good luck!

David Shamouelian, MD · Answer

Hello and Thank you the question. 
Given your pictures, it will likely take potentially 1-2 syringes only. This will depend on your aesthetic goals and the filler your practitioner recommends using. 
Good Luck and I hope this helps!
Dr David

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  The amount of filler you need really depends on a variety of factors, including your specific facial anatomy and bone structure, the thickness of your skin, the extent of your volume loss, and your aesthetic goals.  I also find that many patients with prominent tear troughs often benefit from fillers in the cheeks as well - deep injections on the cheekbones actually help lift the whole cheek and the tear troughs, minimizing the amount of filler that needs to be injected directly under the eyes. I think is generally best to start conservatively in the tear troughs, with 1 syringe per treatment session.  It's always much easier to add filler with time than it is to remove any unwanted product.  The tear troughs and under eyes are among most complex areas to inject with filler, and require a great deal of expertise.  Filler injections here should really only be performed by experienced cosmetic dermatologists or plastic surgeons.  Best of luck!

Mitchell Chasin, MD · Answer

When it comes to dermal fillers under the eye, I find it very rare to need over 1 syringe, or 1cc, of filler. When I do need more than that, it's typically because the cheek is significantly sunken in due to weight-loss or advanced aging. Neither of those appear to be the case here.
You are young, your skin quality appears pretty good for the under eye, and you have a very distinct issue with volume loss that doesn't appear to be widespread. I think you're the perfect candidate for under eye fillers and it would be very easy to make you very happy with that treatment.
One tip I do have: consider requesting Restylane Refyne (I believe it's called Emervel Classic in Europe) as the filler used. It's a different kind of dermal filler than previous products, and will provide a smooth result that move naturally and lasts much longer than other fillers.

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