The under-eye is the most-treated and most-mistreated area in aesthetics. Our approach is conservative.
Eye filler is the most-asked-for and most-mistreated injectable in the industry. Done well, it transforms tired-looking eyes with subtle, natural results. Done poorly, it causes puffiness, lumps, bluish shadowing, and a face that looks worse than before.
Our approach is conservative. Many clients come to us expecting filler and leave with a different plan. There are good reasons.
The under-eye anatomy. The skin is thin. The vasculature is close to the surface. Filler placed even slightly off-target can pool, migrate, attract water (causing puffiness), and become visible. The product can also produce a bluish discolouration called the Tyndall effect, which is difficult to reverse and can last months.
Who is a good candidate. Clients with genuine tear trough hollowing where the bone is recessed and the structural void is what creates the dark shadow. Skin in good condition (thicker, less translucent). No significant puffiness or fluid retention in the area.
Who is not a good candidate. Clients with very thin or pigmented skin. Anyone with eye area puffiness, the filler often makes it worse, not better. Clients whose dark circles are vascular (the blue or purple shadow you see in clear skin), filler does not fix that. Clients with skin quality concerns alongside hollowing, the skin needs treatment first.
What we use instead. For most clients with under-eye concerns, salmon DNA polynucleotides are a better starting point. They address skin quality and texture, the very things that filler does not improve. After a course of polynucleotides, we reassess whether any filler is actually needed.
When we do use filler. Small volumes, deep placement (on the bone, not in the soft tissue), conservative technique. We rarely use more than 0.3 to 0.5 ml total across both sides in a single session. We can always add more, we cannot easily remove the excess.
The honest framing. Eye filler is a precise tool with a narrow indication. It is not the default treatment for tired-looking eyes. A proper consultation should explore the alternatives before reaching for the syringe.