Use of Artefill / Bellafill under the eyes?

I'm wondering about the current line of thinking about the use of Bellafill under the eyes for dark circles. I see some doctors here not recommending it be used there, although some of those remarks are a couple years old.

Doctor Answers 10

Bellafill or Artefill for Under the Eyes

Bellafill is my preferred choice for filler under the eye. You should be very careful about who is placing it however. As a national filler consultant, I see problems with all the fillers under the eyes an almost all of the time it is due to injector error. However, as a particulate filler that asks your body to create its own tissue, Bellafill when “airbrushed under the skin” with a micro-cannula gives wonderful results that at times can be remarkable.

Because it lasts so long, you should be aware of the risks and benefits of these types of fillers. I have added a video that may help you.

I have also added a web reference with a number of photos or patients who were treated with Bellafill under the eyes.

I hope that helps.

Best regards.

Kirkland Plastic Surgeon
4.9 out of 5 stars 62 reviews


This is a technically difficult area to inject.  I would suggest a "dilute" BellaFill (mixed 1:1 with lidocaine) placed just on top of the orbital rim.  Inject no more than 0.5cc of dilute BellaFill for each eyelid and then touch up if more volume wanted.  Be very careful to only use an injector experienced with BellaFill.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 42 reviews

Artefill/Bellafill under eyes

I would not recommend using Bellafill (formerly Artefill) under the eyes.  My preference is to only use one of the hyaluronic acid fillers (such as Restylane) under the eyes.  Because the skin of the under eye are is so thin, sometimes a visible irregularity can develop when filling the area and I find the hyaluronic acid fillers to be the least likely to cause any issue.  Hyaluronic acid fillers can also be dissolved, if needed, unlike the other fillers.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Bellafill Under Eyes

Bellafill (formerly Artefill) was FDA approved in 2014 as a filler. It is promoted as a permanent filler because a portion of the filler is made of microspheres of methyl methacrylate.. The large proportion(80%) is made of bovine collagen.  Collagen last less than one year while the PMM is permanent. You need to be skin tested a month in advance. The injections are meant to to sub-dermal meaning it is placed beneath the skin. This leans itself to be a good filler for the tear trough especially if it is injected just above the bone. As with any filler more is not always better. Being conservative with the injection around the eye is a good idea. Using a microcannula is another way to minimize the bruising.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 25 reviews

Bellafill vs. other fillers in the under-eye area

Thank you for the great question. I do NOT recommend placement of Bellafill in this area. I use exclusively hyaluronic acid (HA) products in this area -- mostly Restylane and Belotero. If you are looking for a longer-lasting alternative for the tear troughs, I would recommend structural fat grafting. This is a minor surgery with a short recovery. Bellafill is fantastic for areas of the face with thicker skin -- the cheeks and nasolabial folds -- and even along the jawline.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Bellafill in Tear Troughs

I use fat, Bellafill and hyaluronic acids under the eye.  Although the HA do attract water and have the possibility of a Tindall Effect that has not been a major problem for me.  This may be because I place my filler very deep, just over the bone, which gives a very natural result.  It is a great choice for a patient who wants to "try out" the filler.  Fat is great because it is permenant but a little more involved to get with a little more down time.  Bellafill has been a great office option for my patints as well.

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.7 out of 5 stars 45 reviews

Bellafill under the eyes

Bellafill is now my favorite filler under the eyes because of its longevity, predictability and lack of Tindall effect. DO NOT go to a novice injector for this unforgiving area.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 38 reviews

Belafill Under Eyes

I suggest avoiding any permanent fillers in large quantities under the eyes unless they are done by a very meticulous surgeon using cannulas for injections. I use radiesse and fat in those areas and have good experience with Belafill as well, but it all depends on the individual person and their long term goals.  I suggest going to a facial contouring specialist for treatment.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Bellafill can be used conservatively under eye area

Pigmentation in the under eye area is different than a tear trough.  Don't expect this to improve but expect the shadows to improve.  It can be used in this area by a very experienced injector.  Because it is permanent, it needs to be conservatively.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Bellafill complications around the eyes

Our office is a regional referral center for filler complications and we continue to see longterm complications from fillers, including Artefill and Bellafill. We do not recommend the filler around the eyes. 

Dr. Karamanoukian 
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 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.