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.

The under eye area is extremely vascular and delicate. It is possible to inject filler under the eye while on plavix, but this will certainly increase the probability of a bruise. Since botox is applied very superficially in the skin, there is a much smaller chance of bruising than with restylane under the eyes as that is injected much more deeply.

Orbital fat loss is probably the most important contributor to the aging of our eyes. In some people it leads to hollowness while in others it leads to loss of support of the brow and upper eyelid with resultant sagging and drooping. Adding volume is the most effective and most natural way of making the eyes look much more youthful, while also adding support to the eyelids leading to better eyelid function. Some people with complaints of dry eyes actually can benefit from adding volume and hence support around the eyelids. This might improve their dry eye problems.

What is the best way of adding volume? Fat or fillers such as restylane? Both can be effective and can have similar results. I routinely use both so can speak of the pros and cons of each. Fat injections can work very well in the upper eyelids. It is a bit less effective and can have more issues in the lower eyelid with potential for lumps. In the upper eyelids there could also be lumps from it but it is less of an issue. Fat injections are not the most predictable way to add volume because of the variable of how much fat will actually "take" in each area. It is not uncommon that a touch up will need to be performed several months after the first procedure.

The advantage of using fillers include ease, short recovery times, and much higher predictability that fat injections around the eyes. It takes just a few minutes to perform and you are set to get back to life as soon as the procedure is over. There of course can be some swelling and occasional bruising from filler injections around the eyes, but it is usually significantly less than fat injections for orbital fat loss. Fillers, of course, are not permanent, or at least Restylane isn't. In my experience filler injections around the eyes last a long time, sometimes several years, especially in the upper eyelid.

Both fat injections and fillers are great ways to add volume and support around the eyes for orbital fat loss. During your consultation the specifics of each will be discussed.

To learn more about orbital fat loss and eyelid surgery please visit our Eyelid Surgery page.

By Gal Aharonov

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.

The skin around the eye is very thin. Injecting fillers such as restylane and juvederm around the eye needs to be done by someone with plenty of experience. When done properly, injections of these "collagen" type products can be very beautiful and natural looking, but when done incorrectly can cause the issues you mentioned your friend having.

Your friend's lumps and issues can be reversed and fixed using a dissolving agent to melt away the filler. If she would like, she can have the procedure redone properly to have a more natural result without any of these issues.

Under eye filler is a quick and easy in office procedure that can be done in less than 20 minutes. It is pain free and you will see results right away. It will not be the final results because you will have slight redness and puffiness, but with a bit of cover up you should be presentable right away. Below is an example of a man with under eye dark circles and under eye hollowness. The after pictures were taken IMMEDIATELY after the procedure. as you can see, there is slight redness, and a small area of blanching (whiteness of the skin). The white effect is from the numbing medicine and goes away after about an hour. Most of the redness is from ice application to the skin. He is not wearing any make up at all.

Before and After under eye dark circles treatment

Before and After under eye dark cirlces treatment

You can also read more about your options at our under eye dark circles page

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.