Do you agree that I'm not a good candidate for under eye filler? (Photos)

Question

My nurse injector said I was not a good candidate for under eye filler. I went in to get filler from my nurse injector who does my Botox and she said I was not a good candidate for under the eyes because I have dark circles and puffiness (which I thought was the point of filler under the eyes) she said I needed IPL under the eyes for broken capillaries, which I don't think they are. They are dark circles I’ve has since I was a kid. Am I not a good candidate? Or should I get a second opinion. I left really confused on the reason why people get filler under the eye.

Nima Shemirani, MD · Answer

Hi @9rzKcaenj01iief. The upper cheek is a major support for the under eyes. So when there is volume loss there, not only do the cheeks reflect this, but the under eye can as well with the development of tear trough and under eye hollows. Addressing the volume deficit in the cheeks with the use of a volumizing hyaluronic acid filler would be a reasonable place to begin. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Monica Boen, MD · Answer

If the filler is administered by a very experienced, board-certified dermatologist, my guess is you would get a good result from some well-placed filler. The filler adds subtle volume to this delicate area, which smooths away the puffiness and reduces the discoloration. It is a more challenging area to treat, which is why experience and expertise are paramount. I typically use a cannula for injecting this area, because this technique tends to reduce bruising and swelling while achieving a natural result.

Sirius K. Yoo, MD · Answer

Based on your photos, you appear to be a good candidate for under eye filler.  It will fill the hollowing and sulcus between the eyelid and cheek.  Keep in mind that this should improve the contour and shadowing caused by the bag, but will not correct the pink/purple skin color.  Usually, this is less of a concern for people because color can be covered by makeup unlike shadowing.  All the best!

Jason Emer, MD · Answer

The issue is that fillers alone will not address the dark circles. A combination of non-invasive, less-downtime options such as fillers, lasers, microneedling/PRP, Cosmelan peels and stem cells can all help give some improvement. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Michael A. Zadeh, MD, FACS · Answer

Thank you for your question and pictures. You do have puffiness under your eyes, but you also have volume loss in the tear trough area. I do not agree with your Nurse. Some expertly placed filler can help camouflage the puffiness and smooth the transition from the under eye area to the cheek. I can't see your cheeks in the pictures, but I would guess that you may also benefit from some filler to the cheeks. Milia is very common under the eyes and is not a contraindication for filler injections. IPL will be useless for you. I would recommend you see a more experienced physician injector for an in-person consultation and evaluation. Best wishes.

Benjamin Barankin, MD, FRCPC · Answer

You're an ok candidate for under eye filler. This is a difficult area to treat, and in your case, the results will be ok to good, but likely not "great" due to the swelling you have above the tear trough. Most importantly when treating such a delicate area, make sure to have a highly trained and experienced cosmetic physician injector such as a dermatologist treating you to optimize results and safety. Many nurse injectors avoid this area, and discourage its treatment due to lack of training and experience.

Praven Chetty, MD · Answer

Dear 9rzKcaenj01iiefLooking at your photos, I would highly recommend seeing an alternate practitioner or physician for treatment of your under eye area with fillers.  Under eye fillers would help to decrease the concave depth transition plane between your eyelids and cheek and create a refreshed appearance.  Please see an expert injector for best results.  Best wishes. Dr. Praven Chetty

Lamia Wassef, MD · Answer

Thanks so much for your question. You can try the filler under the eye like beltero balance or intense or restylane define or rednsity II
The results may not 100%
But fillers are temporary fix for your problem
Good luck
Dr Lamia Wassef, Ottawa