This could vary from person to person and from issue to issue. There are different reasons to inject filler around the eye such as under eye bags, under eye hollowness, upper eyelid hollowness, and upper eyelid laxity and droopyness. Filler needs to be injected in different ways to correct each of these issues. That is why there is no standard way to inject filler that is applicable for every issue.

Different people will react to filler differently. Some might swell a large amount, some might not swell at all. Some will not bruise at all, some might have significant bruising. Sometimes it is just luck, other times people might have a propensity to swell or bruise.

It also takes filler a few weeks to soften up and feel more natural. In thicker skin areas this is not a noticeable issue, but around the eye the filler might be palpable and sometimes noticeable for a few weeks.

Injections around the eyes should be taken as seriously as surgery at times. True, a majority of people will look great almost immediately and not have any problems, but a small number of people will have significant swelling and bruising. Make sure you are mentally prepared to maybe be one of those people before deciding to have injections around your eyes. Just because your friend came to me and looked amazing the next day doesn't mean that you are guaranteed to have the same result.

Upper eyelid filler lasts longer than almost anywhere else on the face or body. Routinely I have patients for whom it has lasted for over 3-4 years. When it slowly dissipates it usually does so uniformly. This makes upper eyelid filler a really great value for improving one's appearance. You must remember that there will continue to be aging changes taking place over those few years as well, so to maintain the aesthetic result you might want to top off your upper eyelid filler treatment every so often.

Under eye dark circles and under eye bags can be due to many different reasons. Each patient needs to be evaluated for their specific cause for their problem. The following is a list of several different contributing factors for under eye dark circles or bags:

1. Presence of an under eye fat bulge or orbital fat
2. Hollowness of the superior cheek or groove
3. deficiency of the inferior orbital rim (the cheek bone supporting your eyeball)
4. Hyperpigmentation of the lower eyelid skin
5. Thin under eye skin with visibility of underlying veins and muscle
6. Overly dark under eye muscle
7. Increased vascularity of under eyelid skin and fragile leaking veins

Several of these factors might be present at the same time and can contribute to the appearance of under eye dark circles or bags. These need to be identified and treated accordingly.

Sometimes filler needs to be placed deeper and sometimes more superficially. Some of the above factors have yet to have a dependable treatment. During your consultation we will go over all the factors that are contributing to your problem and what can or can't be addressed.

The end result should be natural looking without appearance of lumps or problems.

By Dr. Gal Aharonov

For people with true under eye bags and not just under eye hollowness, there are several choices for treatment. The first is non surgical and involves injecting fillers such as restylane under the eye to conceal the bag by raising the skin just below the bag to meet it. This is a quick and painless in office procedure. You can read more about it by going to the non surgical eyelid lift page

Fat injections can also be used to feel in the hollowness below the bag. This is a good option for people who did not have a bag when they were younger, and who's bag isnt that large.

The last choice is whats called lower eyelid fat repositioning or transposition. In this surgery the fat bag is not removed, but is just moved downwards where the hollowness is below it. The only incision is on the inside of the lower eyelid, so it is not visible. It is better to perform this surgery than to remove the bag. Removing the bag will lead to your eyes looking more hollow and gaunt as you age.

If a filler agent such as juvederm or restylane is placed too superficially in the skin, it could cause this bluish effect you are describing.

The only way to reverse it is to dissolve the juvederm, which is possible, which will get rid of the bluish color. Afterward if you would like you can have the filler placed again but at a deeper level so it does not cause the blue effect again.

As we age, we lose volume in our upper face and especially around our eyes. What do I mean by volume? Our facial fat goes away. If you looked at pictures of yourself from when you were younger, you had more volume--more facial fat. Bigger cheeks, more fullness in your temples, brows, and under eye area. As we lose this volume our skin droops and becomes looser. This is also because we lose some elasticity of the skin with age as well.

In the upper eyelid area, the main contributor to the appearance of loose skin is fat loss. We do lose some elasticity but not to a high degree. Most surgeons who perform upper eyelid surgery or a lid lift (blepharoplasty) not only cut away this loose skin but also cut away even more of this brow and eyelid fat! This gives your upper eyelids a hollowed out sunken appearance. No loose skin but the eyes become skelatonized. This does not make you look like you did when you were younger.

Is there a way to help you? There might be. Replacing some of the volume back into your eyes, either with fillers like restylane, or with your own fat, can decrease the hollowness and sunken look of your eyes. It can help bring the life back to them and make them look more like they did when you were young.

Check out the non surgical eyelid lift page for more information.

It seems that you had the filler injected too superficially. When filler is injected right under the skin and not deep enough, something called the Tindel effect happens which imparts a bluish hue to the skin. So even though your dark under eye circles are filled in, it imparts a bluish color which makes you look like you still have dark circles.

This effect does not happen when the filler is injected a bit deeper, which is the way I prefer to inject under the eyes.

It is possible to reverse the effect by dissolving the filler which can be done quickly and easily in the office. Once the filler is dissolved you can choose to have filler done again in the proper place.

Many doctors prefer to inject under eye dark circles superficially because they fear injecting deeper, and also because it takes less material to inject superficially and have the same surface effect. I inject a bit deeper because it consistently has superior results that are more natural.

feel free to visit the under eye dark circles page for more information.

Using filler under the eyes is a procedure I do very very frequently. In fact, it is possibly the most common procedure I perform. My filler of choice under the eye is restylane and juvederm. With the injection technique I use, you will NEVER have a lump or bump under your eye. The procedure is virtually pain free-- the area is numbed before the injections. The only downside is an occasional bruise, which happens about 20% of the time, and mild swelling that might last a couple of days. If you do bruise, it usually lasts just a couple of days, but on rare occasion could last up to 7 to 10 days. Most people feel that they can easily cover up the bruise with concealer.

Filler under the eye, as well as in the brow, create a natural youthful appearance to the eyes. Fillers are extremely safe when done properly, and have a built in safety mechanism of being able to be dissolved in the event that you might not like the result. It is VERY RARE for me to have to dissolve any of the fillers I inject.

Using fillers is extremely operator dependent. It is not the filler that causes bumps it is the injector and the techniques he/she uses. When you choose who to go to for your fillers remember: cheaper is not always better. you are not only paying for the product; you are paying for the injector.