Under-Eye/Tear-Trough Filler

Dark circles under the eyes are a common problem that can be seen in youth and with aging. In young people, it's often due to genetic factors and can be exacerbated by lack of sleep, allergies, dehydration, and erratic lifestyle.

Lack of subcutaneous fat in a naturally concave inner eyelid area with thin skin creates hollows and shadowing. As we age, the eyelid skin becomes thinner and facial compartments shift, creating bags and exacerbating dark circles.

The most common treatment for undereye hollows causing dark circles is dermal filler. The key to a successful result is selecting the right candidate for this treatment. Patients with no or minimal undereye bags, excellent skin tone and primarily volume deficiency (hollowness) are the best candidates. Those with undereye bags and/or loose eyelid skin are better suited for surgery and skin-tightening treatments such as lasers. The eyelid area is very unique, and fillers behave differently there than they do in other parts of the face. Even in the right candidate, correct filler selection and proper technique by an experienced provider is imperative to have a good result and avoid complications.

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Who is a Candidate for Under Eye Filler and Why?

What is under-eye filler?

Under-eye fillers are an injectable treatment designed to add volume to the area under the eye. Dr. Levin only uses hyaluronic-acid (HA) fillers around the eyes, selecting specific types of HA fillers with the right properties. There are only a few that meet the requirements to be used in the eyelids. The goal of treatment is to create a smooth transition between the eyelid and the cheek, improving or eliminating the dark depression and separation between the two areas.
As an eyelid surgeon, Dr. Levin has a thorough knowledge of the eyelid anatomy. To look natural, fillers must be placed deep under the skin and muscle. Placement too close to the skin causes persistent swelling and a bluish “fluid” appearance (tyndall effect). Treatment can be done with a blunt microcannula or a small needle. Dr. Levin is proficient in both techniques, most commonly using the cannula as it is less traumatic and safer.

What can I expect during my treatment?

Dr. Levin begins with a consultation to examine your face and skin, discuss your aesthetic goals and decide whether filler is your best option. If she feels that you are not a candidate for filler, she will explain why and offer alternative treatment options.

Some patients prefer to have a numbing cream applied. Many patients prefer to use ice as an anesthetic to avoid skin irritation from numbing creams and feel that the treatment is still very comfortable. A very fine needle or blunt-tipped cannula is used to inject small amounts of HA filler into the areas under your eyes. This is done precisely and carefully. However, in the skilled hands of Dr. Levin, the injection period will only take a few minutes.

Before & After

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Recovery and results

After a treatment of under-eye filler, you can get right back to your day, returning to work or your usual activities as soon as you leave the office. Bruising is possible but not common, whereas some swelling is expected. Swelling usually lasts 3-5 days and is often described as mild. We recommend not exercising for 24 hours, and avoiding heat or massaging the area for 2 weeks after the procedure.

You will be able to see the results immediately--rejuvenated, bright and less tired-looking eyes. It is important to understand that under-eye fillers do not help improve wrinkles. Other treatments, like skin laser resurfacing or microneedling, are necessary to address those concerns.

Another contributing factor to dark circles may be skin hyperpigmentation, unrelated to the hollowness. If present, topical treatments with bleaching creams are necessary to make the skin more evenly colored.

Dr. Levin recommends a followup 2 weeks after treatment to assess the results and sometimes do a touch-up. The results are expected to last 10-12 months.

Why choose Dr. Levin?

Dr. Flora Levin is a true specialist when it comes to rejuvenating the area around the eyes. She is a board-certified, nationally and internationally recognized oculofacial plastic surgeon specializing in eyelid and face rejuvenation. Dr. Levin’s philosophy is that after treatment with fillers, nobody should be able to tell what was actually done. Her goal is to allow you to look rested, refreshed, and always natural. What patients appreciate most about their consultations with her is her honesty, as she does not recommend treatments that she does not believe will work. She represents the best of the best, giving every patient the benefit of her long experience, expertise and dedication to their aesthetic vision.