When you think of dermal filler, what’s the first thing that comes to mind? Fuller lips? Shapelier cheeks or a more defined chin, perhaps? While it may not be the most well-known use for hyaluronic acid injectables, treatment of the under-eye area is seeing an undeniable upsurge in interest thanks to its ability to fill hollowness and camouflage dark circles in a way topical skincare products never could. But with some very impressive results has come a fair amount of scrutiny.
If you’ve been contemplating an appointment for under-eye filler, it’s important to go in with as much information as possible. I spoke with New York-based board-certified dermatologist Marnie Nussbaum, MD, Palm Beach-based board-certified plastic surgeon Mark Murphy, MD, and Newport Beach-based board-certified plastic surgeon Goretti Ho Taghva, MD, to help you get a thorough understanding of under-eye filler, from the reasons it has risen in popularity to why some patients—and doctors—have moved away from it altogether.
What Is Under-Eye Filler?
Dermal filler is a nonsurgical treatment made from hyaluronic acid, a molecule naturally found in skin that retains moisture and supports connective tissue structure, according to Dr. Ho Taghva.
“While there are different molecular structures and cross-polymer versions,” Dr. Nussbaum says, “lightweight hyaluronic acid fillers tend to work best for the delicate under-eye area.”
In other words, not every dermal filler is the ideal molecular weight for this area; the one a skilled injector would use to shape the chin would very likely not be the one they would use under the eyes. “Common product lines include RHA 2, Juvéderm Volbella, and Restylane Eyelight,” Dr. Ho Taghva says.
What Are the Key Benefits of Under-Eye Filler?
When writer Elise Minton started getting under-eye filler in her twenties, she was excited to find a nonsurgical approach to the area. “I've always had pretty deep hollows, which I hated,” she says, and that’s one of the key concerns addressed by under-eye filler.
“Under-eye filler helps correct volume loss, hollowness, and, to an extent, dark circles that are caused by shadowing due to deep tear troughs,” Dr. Ho Taghva says. “It can improve the lid-cheek junction, creating a smoother contour between the eye and midface.”
Although the results can be immediate, it greatly depends on how much filler is injected and where. It may even result in some bonus benefits. “A skilled injector will place the filler slightly lower—along the cheekbone—to create a natural lift that softens dark circles and smooths nasolabial folds,” says Dr. Nussbaum, aka the "smile lines" that run from your nose and around your mouth.
Although it treats the same area, Dr. Murphy emphasizes, “[Under-eye filler] is not a substitute for lower lid blepharoplasty,” which removes tissue, as opposed to adding volume. “A lower blepharoplasty surgically addresses fat protrusion (eye bags), skin laxity, volume mismatch, and any malposition of the lower lid—issues that filler cannot correct,” Dr. Ho Taghva explains.
Who Is a Good Candidate for Under-Eye Filler?
Age is a major factor when it comes to being a good candidate for under-eye filler—but not in the way you may think. “As you age, the skin thins and makes intervention with filler in this area highly challenging,” Dr. Murphy says. Dr. Ho Taghva agrees, adding that those with pronounced fat pads (eye bags) are not good candidates, as filler can accentuate puffiness.
Even more than age, facial anatomy—such as a tear trough deformity or significant hollowing—is the biggest consideration. “If you constantly hear, ‘You look tired,’ even after a good night’s sleep, filler might be something to explore with your dermatologist,” explains Dr. Nussbaum, who says that the best results are seen in people with mild to moderate under-eye shadows and a bit of crepiness.
How Long Does Under-Eye Filler Last?
Over the years, experts have changed their opinion on how long filler is expected to last, and the jury is still out. In fact, I received three different answers from three different doctors. Dr. Nussbaum estimates under-eye filler will last six to 18 months, while Dr. Ho Taghva believes it’s a narrower range of nine to 12 months. Dr. Murphy, on the other hand, says it’s a question that can’t be answered definitively.
“My experience is that once you put something in there—speaking of hyaluronic acids, specifically—some of it will always be there, and it's impossible to know how much will last,” he says.
And it’s that very reason why Minton decided to stop getting under-eye filler at 40. “I liked how the filler looked so much that I kept up with regular injections about once a year. Everything was going great until there was so much filler layered over the old filler,” she says. “My face started looking too puffy for my liking, and over time, I slowly developed a bit of a filler shelf.” She has since had her lingering under-eye filler dissolved.
Complaints of a puffy look are also why Dr. Murphy’s practice has moved away from administering under-eye filler. “Under-eye filler has been a very popular treatment, but I stepped away from offering it a few years ago,” he says. “The area is extremely delicate, and even well-placed filler can lead to long-term puffiness that’s difficult to correct.” He has also taken what he calls “small but real safety risks” into consideration, shifting more toward the more predictable results of fat transfer. (More on that later.)
What Are the Risks Associated With Under-Eye Filler?
As with other injectable treatments, temporary, mild swelling and bruising are common. However, under-eye filler comes with its own unique risks. “The under-eye area is one of the most technically challenging places to inject filler,” says Dr. Ho Taghva, who notes that many practitioners struggle with this area because it requires precise placement at the correct depth. “If filler is placed too superficially or unevenly, it can cause lumpiness, unnatural contouring, or the Tyndall effect—a bluish tint under the skin.”
In addition to filler migration and impairment of lymphatic flow, Dr. Nussbaum says one of the more serious complications associated with under-eye fillers is vascular occlusion, which can lead to vision loss. “[It’s] rare but can happen, which is why it’s crucial to see a board-certified dermatologist or a highly-experienced injector,” she says.
How Much Does Under-Eye Filler Cost?
A number of factors contribute to what you’ll pay for under-eye filler, including region, injector expertise, product used, and, of course, whether you’re treating one or both sides. But according to the doctors I spoke to, you can expect to pay between $500 and $2000.
Are There Alternatives to Under-Eye Filler?
As generally safe and effective as hyaluronic acid fillers are for treating the under-eye area, there’s understandable appeal to filler derived from one’s own body. “For those seeking a natural or regenerative alternative, PRFM (platelet-rich fibrin matrix) and EZ Gel are great options,” says Dr. Ho Taghva, who explains that both treatments are made entirely from your own blood and processed into a smooth, gel-like filler that adds subtle volume and stimulates collagen production over time. “Because they come from your body, they integrate seamlessly with your skin and carry virtually no risk of allergic reaction or the risks associated with traditional fillers.”
Similarly, Dr. Murphy is a fan of fat transfer under the eye. “Fat is what you've lost, so it stands to reason to replace what was lost with the same tissue,” he says. “It lasts longer than any other volume replenishment modality, and it also contains stem cells that improve the overlying skin over time.”
Ultimately, to make the decision that’s right for you, it’s imperative to have a consultation with a highly qualified injector who can help you choose whether you’re the right candidate for under-eye filler or another approach for your under-eye concerns.
Meet the Experts
Dr. Mark R. Murphy, founder of Palm Beach Facial Plastic Surgery, is regarded as one of the most qualified surgeons to perform facial plastic surgery procedures from around the globe. Across a decades-long career in medicine and plastic surgery, he has mastered a variety of plastic surgeries and treatments and pioneered the Elévolve facial approach to achieve a natural look. Dr. Murphy is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery, and the American Board of Otolaryngology-Head and Neck Surgery.
Dr. Marnie Nussbaum is a board-certified dermatologist and nationally recognized expert in non-invasive face and body rejuvenation. Known for blending the latest science with artistic precision, she helps her patients achieve natural, effortless results that build confidence at every stage. After 20+ years of listening to her patients, she created her namesake skincare line to bring the same honesty and efficacy from her Manhattan practice into daily routines. Backed by science and clinically tested, each formula is designed to deliver visible results—instantly and over time—while extending the benefits of in-office treatments.
Dr. Goretti Ho Tagvha is a board-certified, Ivy League-educated plastic and reconstructive surgeon. With expertise in both surgical and non-surgical facial and body rejuvenation, Dr. Ho Taghva performs a diverse range of surgeries including blepharoplasty, fat transfer, rhinoplasty, breast augmentation, breast lift, facial rejuvenation, mommy makeovers, and minimally invasive endoscopic procedures.
