Under Eye/Tear Trough Filler: Everything You Need To Know (Updated 2023)

Before-and-after results of MFI under eye filler patients and text that reads 'Dermal Fillers For Eye Bag Treatment'

Brighter, Smoother Under Eyes in Minutes 

Hi, it’s Kimberly! I’m excited to write today about one of our most rewarding procedures: under eye filler. I perform this treatment on people of all ages who are tired of looking tired. Some of us are just inclined to have circles, shadows, or bags under our eyes. This treatment is the perfect refresher, making a big impact on your appearance, yet no one has to know you had fillers. It’ll be our secret.

Before-and-after under eye filler case #739
Before and After Under Eye Filler

Under Eye Filler for Dark Circles 

There are a few ways under eye fillers can improve the appearance of the face in both men and women. Under eye filler can help improve dark circles by creating a smooth, light-reflecting surface free from shadows. Take a look at this example:

Before-and-after under eye filler for improving dark circles case #769
Before and After Under Eye Filler: Improving Dark Circles

Under Eye Filler for Bags 

Under eye filler is also great for improving the appearance of puffy bags beneath the eyes. We strategically place the filler to create a smooth under eye area that blends seamlessly with the upper cheek. You can see the dramatic results in this patient:

Before and after under eye filler for improving under eye bags case #641
Before and After Under Eye Filler: Improving Under Eye Bags

Under Eye Filler at Any Age

At MFI in San Francisco, we see under eye filler patients of all ages. This procedure makes a tremendous difference in a person’s appearance and confidence—you’re never too young or old for that!

Before and after under eye filler for a patient in their 20s case #584
Before and After Under Eye Filler For a Patient in Their 20s
Before and after under eye filler for a patient in their 30s case #737
Before and After Under Eye Filler For a Patient in Their 30s
Before and after under eye filler for a patient in their 40s case #404
Before and After Under Eye Filler For a Patient in Their 40s
Before and after under eye filler for a patient in their 50s case #723
Before and After Under Eye Filler For a Patient in Their 50s
Before and after under eye filler for a patient in their 60s case #603
Before and After Under Eye Filler For a Patient in Their 60s
Before and After Under Eye Filler For a Patient in Their 70s
Before and After Under Eye Filler For a Patient in Their 70s

Preparing For Your First Under Eye Filler Treatment

You can do a few things to prepare for your under eye filler appointment. 

  • A few days before your appointment, limit natural or artificial blood thinners such as anti-inflammatories, fish oil, and alcohol. Limiting these will reduce your risk of bruising from under eye filler. DO NOT discontinue prescribed, medically necessary, medications. 
  • Find and bring any inspiration photos of under eyes you like. This will help your Injector better envision what your treatment goals are. 
  • Eat and drink a normal breakfast or lunch prior to your appointment; low blood sugar can make patients lightheaded during treatment. 

Under Eye Filler Treatment 

Consultation for Under Eye Dermal Filler

Successful under eye filler experience starts with a thorough consultation. To begin, we first establish your aesthetic goals and expectations. This is your chance to make sure we’re the best match to help you reach your goal of a perfect bright-eyed appearance. Afterward, we become the paparazzi and take professional-level photographs of your under eyes from all angles. We use these photos at every visit to identify concerns and monitor progress. Using both the photos and an in-person examination, we map out a customized treatment plan tailored to your under eye anatomy and goals.

Complete collection of before and after photos for patient case
In-Office Professional-Level Photos of a Filler Patient From All Angles

Is Under Eye Filler Treatment Painful?

A lot of patients are concerned about the pain of under eye filler treatment, but we have numerous techniques to help alleviate discomfort. We use a combination of topical lidocaine and injectable lidocaine to numb the area. For those who may be a little extra anxious, we also offer nitrous oxide (aka. laughing gas) to help calm some of your nerves. As a bonus, all our fillers have lidocaine in them, so the treatment area continues to become more numb as the under eye filler treatment continues.

Learn More in This Video: Do Fillers Hurt?

For the most part, under eye fillers are not very painful and are well tolerated.

The Best Filler For Under Eyes

JUVÉDERM® VOLUMA™ and Restylane Lyft® for under eye
JUVÉDERM® VOLUMA™ and Restylane Lyft® for Under Eye

The skin under the eyes is very thin with minimal fat under the skin, therefore, the best filler for under eyes is a soft, moldable, hyaluronic acid filler. We use Restylane-L in the under eyes.  But, before the under eye can be appropriately treated, the midface needs to first be volumized so that it can support the under eye. While the under eye requires a softer moldable filler, the midface requires something more supportive. We use Juvederm Voluma or Restylane Lyft in the midface. These hyaluronic acid fillers give enough support to lift the heavier midface and cheek skin.

Under Eye Filler Procedure

Now, the part you’ve all been waiting for: under eye filler! The under eye filler treatment is carried out by your Injector, but you’ll also be accompanied by one of our medical staff. They’re there to assist the Injector and monitor your comfort levels. Think of us as your professional pit crew, working together seamlessly to ensure a smooth ride. Your injections themselves will take anywhere from 20-40 minutes, based on your speed and comfort level.

Keys To Treating Dark Circles and Under Eye Bags With Filler  

Treating The Area Holistically

It’s vital to consider the midface when treating the under eye; the two areas go hand in hand. Often, volume loss in the midface is the main culprit of dark circles and under eye bags. When we lose volume in the midface (the area right under the tear trough), we leave the tear trough unsupported and sunken. By using filler to replace the volume first in the midface, we lend the necessary support to the under eye. Once the midface is supported, we can address the tear trough with less filler. No overfilling here! 

Under Eye Filler/Midface Rejuvenation
Under Eye Filler/Midface Rejuvenation

It Takes Two

For natural-looking results, it’s important to layer the filler over multiple visits. This helps to avoid overfilling and creating a puffy, overdone look. When treating the under eyes, you may or may not see improvement after your first visit; at first, this can dishearten patients, but have faith! Your second visit is key to getting the sunken area out of the shadows and brightened. Depending on your anatomy, it could take a third visit! Check out the transformation below: this patient took 3 visits to reach his perfect goals!

man with undereye fillers

Under Eye Dermal Filler Aftercare  

Under Eye Filler Recovery Do’s and Don’ts

DO – Apply ice on and off the under eye for the next 48 hours, and switch to a warm compress after 48 hours.

DO – Sleep slightly elevated, with your head above your heart, the next two nights to help alleviate swelling.

DON’T – Apply makeup or any lotion over the under eyes for the next 4 hours after filler injections.

DON’T – Swim or use saunas in the next 48 hours due to the risk of infection after under eye fillers.

DON’T – Rub or massage the under eyes for the next 48 hours after under eye filler injections.

Graphic outlining filler swelling after treatment

Under Eye Filler Results

While you’ll notice a change immediately after your under eye filler treatment, your actual results won’t be visible until 4 weeks after your under eye procedure. Give your body 4 weeks for the swelling and bruising to resolve; at this point, you’ll see exactly how the filler will lay. Remember, this is only the first step in your treatment! Your results will be most visible after you’ve had your refinement visit. This is where we see you about 1-3 months later to do a second round of filler injections to the same area. 

Under Eye Filler Side Effects  

Common Side Effects of Under Eye Filler 

Lumps and Bumps After Under Eye Filler

Lumps and bumps are also possible side effects from under eye filler, and they could be present for a few reasons. First and most frequently, they’re due to temporary swelling at the injection site post-treatment, and they subside over the course of 4 weeks as the swelling resolves. Secondly, lumps present after 4 weeks, especially after your first under eye filler treatment, are often due to incomplete treatment. A minimum of 2 visits is necessary.

man with lumps and bumps after filler

Bruising After Under Eye Filler

Bruising after under eye fillers is infrequent but possible. We typically see bruises less than 20% of the time, but just in case, be ready to use concealer to cover some bruising the next day.

Woman with bruising after under eye filler
Bruising After Under Eye Filler

Swelling After Under Eye Filler

Swelling after under eye filler is expected. Swelling isn’t always straightforward, as everyone swells differently, and swelling doesn’t always feel soft like fluid. Swelling can even cause the temporary appearance of asymmetry. While the majority of swelling is gone within the first 2 weeks, there is still residual swelling present until the 4 week mark. Be patient and remember that millimeter changes on the face make all the difference.

Rare Side Effects of Under Eye Filler 

Tyndall Effect After Under Eye Filler

Occasionally, filler can become too superficial and cause what is called a Tyndall effect. This is when the filler gives off a blueish-gray hue, and it happens when the filler is too shallow under the skin; light refracts off the gel filler and gives a blue-colored appearance. This can be reversed by dissolving the superficial filler with hyaluronidase; afterwards, filler can be replaced at a deeper depth.

Before and after images of case #718
Before and After Tyndall Effect

Infection After Under Eye Filler

Infection is a very rare side effect from under eye fillers, however, it is a potential risk with any procedure where the skin is punctured. It’s important that the skin is properly cleaned prior to injections and remains clean while the injection sites are healing. Signs of infection include redness, warmth, tenderness, and swelling; if a patient notices these signs, they should promptly notify their Injector.

Delayed Swelling After Under Eye Filler

Delayed Swelling is an uncommon complication that can occur weeks to months after under eye filler. The exact cause is not fully known, however, on rare instances under eye dermal filler may randomly swell, becoming tender or lumpy. This typically resolves over the course of a few days without medical intervention, however, notify your Injector as medication can be given to help aid recovery. 

Vascular Occlusion After Under Eye Filler

Vascular occlusion is an extremely rare, yet possible, complication from under eye dermal filler. This occurs when filler is inadvertently injected into a vessel, blocking blood flow through the vessel. When the skin does not receive its normal flow of blood, it becomes pale, progressing to pain, and if the flow of blood is not restored, it runs the risk of tissue damage. If this occurs, the filler must be dissolved immediately to restore blood flow. It’s imperative that you see a medically trained professional who is equipped to recognize and handle this complication.  

Under Eye Filler Cost

Initial Pricing for Under Eye Filler

The price for the treatment varies based on the amount of filler needed and the Injector. Factors that influence this include how much, or little, volume your midface and under eye have to start with (aka. your natural anatomy) and your goal appearance. In our office, patients typically begin with the Complete Under Eye Rejuvenation Package. The price ranges from $4,200 to $5,300 and includes 4 syringes of filler and 2 appointments. 

For a select few individuals, approximately 10% of our under eye patients, we can do a mini under eye treatment to correct minimal tear trough and midface volume loss. This single-appointment treatment ranges from $2,400 to $3,200 and includes 2 syringes of filler.

Maintenance Pricing for Under Eye Filler

Once we’ve rejuvenated your under eyes to a place where you’re happy, we switch you over to maintenance. From this point on, we only need to see you once every 9-12 months, and during these appointments we are touching up the midface and under eyes. On average, maintenance for Complete Under Eye Rejuvenation costs from $1,000 to $2,400 per year. For mini or partial under eye treatment, annual maintenance averages $1,000 to $1,200.

Yes, I’m Ready For My Under Eye Filler! 

Schedule Me for Under Eye Filler Treatment

Congratulations, you’ve just made an excellent decision! To schedule your appointment, you can either email us or give our office a call at (415) 445-9513. We can’t wait to meet you and rejuvenate your look with under eye filler!

The MFI Advantage

MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.

Schedule Me

Learn More About Under Eye Dermal Filler

More Before and After Tear Trough Filler Pics

Check out a few of our favorite tear trough filler cases here and in our gallery:

Before & After contouring for Tear Trough Filler face shape
Before & After contouring for Tear Trough Filler face shape
Before & After contouring for Tear Trough Filler face shape
Before & After contouring for Tear Trough Filler face shape
Before & After contouring for Tear Trough Filler face shape


Want to take a deeper dive into fillers for dark circles and under eye bags? Check out some of our videos for more information:

Kimberly Derkach, PA-C

Kimberly Derkach, PA-C

Physician Assistant & Associate Injector Kimberly Derkach, PA-C trained exclusively with Dr. David Mabrie and now works alongside him at Mabrie Facial Institute as an injector and leader in the use of dermal fillers for facial sculpting. Kimberly’s favorite procedure is the Illumination 360° procedure for chin, jaw, and neck because the “results are always amazing for both men and women” and this “quick, noninvasive treatment enhances the facial shape and jawline.”

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