Under-eye filler

Under-eye filler for deep tear troughs, sunken eyes and shadowing, by a doctor

Deep tear troughs, sunken-looking eyes and structural shadows can be corrected with a soft HA filler at 0.5–1 cc per side, but not everyone is suited. The doctor first establishes whether the problem is a deep trough, fat bags or pigment-related darkness.

Medically reviewed by Asst. Prof. Dr. Borisut Sanmano (Thai Medical Licence 23173) · Last updated October 2026

Illustration: a tear trough caused by a receding orbital bone and thin fat, compared with protruding under-eye fat bags

Tear troughs, eye bags and dark circles: what is the difference?

What patients call dark circles or sunken eyes actually falls into three groups that are treated differently. The first is a deep tear trough, caused by the orbital bone and the fat beneath the skin receding with age or being hollow from birth, which casts a shadow even when the skin colour is normal. This group responds well to filler. The second is eye bags caused by orbital fat pushing forward. Filler can partly disguise the groove below the bag, but large bags should be considered for lower eyelid surgery. The third is darkness from pigment or from blood vessels showing through thin skin. Filler does not help here; laser, skin boosters or PRP are used instead.

Who is suited to under-eye filler

Well suited

A tear trough that is clearly deep when you tilt your head up and look in the mirror, reasonably thick under-eye skin, no large fat bags, and aged 25 or over

Suited with conditions

Small fat bags together with a deep trough. A small amount of filler blends the edge of the bag but does not make the bag disappear

Not suited

Very thin under-eye skin, puffiness in the mornings, large fat bags, or old filler still in place. Dissolve the old filler first, or choose another method

Consider another method instead

Darkness from pigment or allergies, or crepey, wrinkled under-eye skin, which suit laser, Plasma Eyes or skin boosters better

How the clinic injects

Assessment sitting up and tilted backTo see whether the trough is truly deep or a shadow cast by a bag, to press-test the skin thickness, and to check for a history of puffiness, allergies or thyroid conditions

A soft filler with low water uptakeThe under-eyes need products designed for thin skin, such as Restylane Eyelight, Juvederm Volbella, Belotero Balance or Teosyal Redensity II, to reduce the chance of swelling and a bluish tint

Blunt cannula placed deep against the boneA single entry point on the cheek, then a blunt cannula places the gel beneath the muscle on the orbital bone, reducing the risk of entering a vessel and of bruising. 0.5–1 cc per side

Less first, top up laterThe under-eye is an area where too much looks worse than too little. The clinic fills to reduce the trough by 70–80% and reviews at 2–4 weeks before adding more

Follow-upReview at 2–4 weeks to check for swelling, unevenness or a bluish tint. Both a top-up and dissolving are possible

Tyndall effect: a blue-grey tint under the eyes

If filler is placed too superficially beneath thin skin, light scatters and a blue-grey patch becomes visible, known as the Tyndall effect. It is not dangerous but looks worse, and it does not resolve until the filler breaks down, which under the eyes can take several years. It can be corrected by injecting hyaluronidase. Placing the gel deep against the bone and using a suitable product are the main ways to prevent it. Another condition seen is slow, puffy swelling months after injection (delayed swelling) in people whose skin retains fluid easily

After injection

Days 0–3Swelling and possible bruisingVisible under-eye swelling for 1–3 days, with bruising in 10–20% of cases. Cold compresses, sleep with your head raised, and avoid very salty food

Weeks 1–2Settling inSwelling subsides, the trough looks shallower and you look fresher. Make-up as normal

Weeks 2–4Review appointmentA top-up if a trough remains, or partial dissolving if there is unevenness

Months 12–24Gradual breakdownThe under-eye area breaks filler down more slowly than other areas, and many people see it last 1–2 years. Return for a top-up when the trough reappears

Alternatives and related services

HA filler, all areas

Tear troughs often improve considerably when the midface is filled as well

Plasma eyes

Crepey under-eye skin and loose eyelids that filler cannot help

Under-eye filler correction

Swelling, a bluish tint or lumps from previous under-eye filler

Under-eye filler, 1 cc (both sides) A product designed for the under-eyes, including blunt cannula, numbing cream and a review appointment	[ ]
Top-up at the review Priced by the amount actually used	[ ]

Most people need 1 cc for both sides. Very deep troughs may need 2 cc, and the doctor tells you before injecting

The information on this page is for educational purposes. Treatment plans and results depend on an individual assessment by the doctor.

Frequently Asked Questions

Will under-eye filler get rid of my dark circles?

If the darkness is a shadow cast by a deep trough, it improves clearly. If it comes from pigment or from vessels showing through thin skin, filler does not help. The doctor tells you which group you fall into at the assessment.

Why does filler last longer under the eyes?

The under-eye area moves less and has a lower blood supply than the lips or nasolabial folds, so filler breaks down slowly and in some people lasts 2 years or more. That also means a poor result lasts just as long, so it should be dissolved and corrected rather than waited out.

Is it true that under-eye filler can cause blindness?

Cases have been reported for injections in every area of the face, including under the eyes, but they are very rare. The clinic reduces the risk by using a blunt cannula, placing deep against the bone, injecting slowly in small amounts and keeping hyaluronidase ready.

I had under-eye filler elsewhere and now it is puffy. What can I do?

Come in for an ultrasound scan to see the position and amount of the existing filler, then dissolve part or all of it. Wait 2–4 weeks before considering re-injection.

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