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Fillers to treat under eye bags

At Harley Street Face Clinic, many patients come to us with a shadow or depression that appears beneath the lower eyelid, this is often termed the tear trough.

Written by Dr De Silva

Why choose dermal fillers for a lower eyelid lift?

This appearance of under-eye bags can give a tired appearance. Patients often find people comment that they look stressed or tired. The changes to the under-eye area are often related to genetics, and sometimes to lifestyle, for example, if you smoke cigarettes.

The junction between the lower eyelids and upper cheek is referred to as the tear trough area. Tear trough hollowing is one of the earliest ageing changes and is often a common feature from childhood. As we get older, this area alters in appearance, by becoming more hollowed, darker, deeper and less revitalised.

In some people depressions can develop can make the eyes look somewhat sunken, creating unattractive dark shadows and giving the appearance of tiredness, exhaustion and old age.

Treatment at a glance

Why

Beautify the face and restore lost volume

How

Use the Phi Golden Radio to produce an outcome that looks natural using long-lasting HA fillers.

Safety

FDA-approved, 'gold standard' fillers, administered with the 'no-needle' cannula technique by practitioners with facial specialist expertise

Duration

Lasts around 12-18 months (although exact duration varies from person-to-person)

Cost

Quantity dependent. The average quantity is 1-2 vials of filler

Pain

Special topical anaesthesia; applied with the cannula technique. Moderate discomfort

Risks

Mild redness, swelling (1-5 days), occasional bruising

Recovery

Most patients are back to normal activity the next day

Complimentary Techniques

Fillers to the chin; lips and skin rejuvenation

Alternative

We offer long-term surgical enhancement (lower blepharoplasty)

Improving the under-eye area

There are essentially two ways in which this can be improved:

  • Non-surgically with tear trough filler (aka non-surgical lower blepharoplasty)
  • Surgically with lower blepharoplasty (eyelid surgery)

Filler treatment is a popular solution for early treatment of these changes to the tear trough. The treatment involves carefully injecting a gel-like substance into specific areas around the eyes, with the objective of softening deep wrinkles and lines.

Treatment to the lower eyelid with filler is a more challenging technique and many non-specialist clinicians do not offer it as it is more difficult to administer than for other parts of the face.

The Liquid Facelift

Combining filler with other treatments including wrinkle injections, skin resurfacing and other facial rejuvenation techniques in a ‘liquid facelift’ can provide a natural, rejuvenated appearance

We use several different fillers for various areas of the face, each specialised for a particular anatomical area. There is a wide array of different filler preparations that are currently available on the market and at your consultation, we will advise you on which will provide the best aesthetic solution for you.

The treatment can result in bruising and swelling. We have developed a customised a state-of-the-art no-needle technique, this focuses on the use of a blunt cannula to provide the treatment, which minimises bruising and swelling to less than 5% of patients. This technique is important in reducing recovery time.

Before & after

Real Patient photo gallery

  • Infection is rare after filler treatment, care is required with hygiene and cleaning the skin before the procedure that avoids these issues. Care is required with technique in this area to avoid complications and ensure a fast recovery.
  • When shaping the contours of the face the crystal-clear gel is injected into the skin in tiny amounts. The treatment takes a few minutes and the results can be seen immediately.
  • Lower blepharoplasty (eyelid surgery) can be used, however, this anatomy is both intricate and detailed, for younger patients with mild changes, non-surgically offers a fast recovery procedure avoiding surgery.
  • Patients with more advanced changes are better suited to lower blepharoplasty, as the filler has limitations to improvement.
BeforeAfter

What does tear trough filler involve at The Harley Street Face Clinic?

A numbing local anaesthetic cream is applied to the areas being treated. Especially, made for us, it was designed in Beverly Hills and manufactured in Germany.

The filler also contains an anaesthetic and combined with the numbing cream should make the experience pain-free.

We use the new fast healing cannula technique to administer the filler, which results in less swelling and bruising so that the recovery is quicker.

Additionally, dermal fillers can be used on other facial areas at the same time as the tear troughs to give an enhanced natural result. Common areas for filler enhancement include the cheeks, chin & jawline, nasolabial folds (laughter lines), nose and lips.

When will I see the results from lower eyelid fillers?

You can expect to see relatively ‘instant results’ with our filler treatments. There will be minor swelling after the treatment, but for most patients this disappears overnight.

There may be mild swelling for 5-days (in approximately 5% of patients), and a small possibility, (<2%) of minor bruising.

For most patients, the final results of their tear trough fillers will be evident approximately 5-days after all the swelling has disappeared.

With our techniques that apply filler at deeper levels and filler choice results can last for 18 – 24 months, although results vary for individuals.

BeforeAfter

Patient 1: “Tear trough filler can be completed to reduce hollowing and shadows beneath the eyelids in younger patients with mild to moderate changes. Our use of a No-Needle Cannula technique, speeds up recovery as 95% of patients have no bruising.

Will I look natural with lower eyelid fillers?

At The Harley Street Face Clinic we pride ourselves on achieving natural-looking results. Our expertise is renowned as we only perform facial treatments (surgical and non-surgical). We have appeared throughout the media and on national television and have talked about all aspects of facial aesthetics, and the Phi Golden Ratio to apply the principles of facial balance.

We offer a conservative approach, avoiding the use of excessive fillers that can result in a bad, overdone result that doesn’t look natural. We are careful to take the individual characteristics of each face into consideration and applying the appropriate amount of filler in the right places to achieve the desired results.

 

Will I experience any discomfort or pain?

Treatment with dermal fillers is not painful, although it may feel a little odd. We use:

  • numbing cream
  • products that contain anaesthetic
  • no need cannula technique
  • vibration devices that use the Gate Control Theory of Pain

This combination ensures that our patients do not experience any discomfort or pain.

Are there any risks or complications?

Dermal fillers are very safe and there have been few reported adverse affects with the hyaluronic acid (HA) fillers.

Adverse events tend to be minor and include redness, itching, swelling and bruising. These tend to last for just a few days.

Although infection is rare, ensuring treatment is performed by a CQC (Care Quality Commission) site is imperative to ensure the most stringent health and safety regulations are adhered to.

All treatments are performed at our  Facial Centre on Harley Street.  Fillers are currently lacking from regulation, which remains a controversy in the UK and why it is crucial you visit a trustworthy facility for your treatment.

BeforeAfter

Patient 1: “A hyaluronic acid filler can be effectively used to rejuvenate the lower eyelid area. Care is required to use a filler with non-absorbable qualities (termed ‘Hydrophilic”). This is key to avoiding swelling after treatment

What Filler treatments are best avoided in the lower eyelids?

We use treatments that provide a natural rejuvenation that is both long-lasting and safe. Over the last 5-years, fillers have become more popular as both the product has reached new levels of quality and safety and our techniques and skills at using them have matured with experience.

Although our team have been using non-surgical treatments for patients for over ten years, we believe that it is important to avoid potential issues. Thus,  there are certain products associated with higher risk issues, including permanent and semi-permanent fillers. In some patients, this can result in long-term issues.

The lower eyelid is an intricate area of the face, and certain fillers should be avoided as they have properties that may result in increased swelling as well as lumps or bumps, which can be avoided. At The Centre, as facial specialists, we have a vast knowledge of facial fillers and the most effective areas for them, as well as those to avoid.

Some patients may have facial anatomy which is characterised by marked changes of their lower eyelids, and these patients are better suited to a surgical correction including the use of lower blepharoplasty with fat transfer.

How long does tear trough filler last?

How long the results from your tear trough treatment using dermal fillers will last will mostly depend on your own individual response to the product. For tear troughs, a very fluid dermal filler is used, so as not to compromise the delicate skin tissues of the under-eye area.

Here at The Harley Street Face Clinic, we only use clinically proven and FDA approved dermal fillers, for safe treatment and a natural look. Depending on how your body metabolises the dermal filler product, you can expect results to last between 18 and 24 months. If you smoke, exercise excessively or frequently sunbathe excessively, the product will not last as long.

What do dermal fillers for the tear troughs do?

Dermal fillers for the tear troughs help to fill out any hollow areas under the eyes. This can help with eye bags as well as the appearance of dark circles under the eyes. They do not contain cross-linking agents and are not thick and heavy, like some dermal fillers for other areas of the face.

They are usually injected into this area using a cannula, as opposed to a needle. A cannula will minimise the risk of bruising and is safer for this very delicate and vascular area. Dermal fillers will not minimise puffiness under the eyes, but they can disguise the hollow areas under these bags and give the appearance of a lighter skin tone.

How long do dermal fillers for the tear troughs take to work?

Results are seen straight away as the dermal filler will fill the lines under the eyes and lift up the skin tissues. There may be a little swelling immediately after your treatment which will settle in around 24 hours.

The skin under the eyes is incredibly delicate and any injectable treatment might cause some trauma to this area, but any swelling is completely normal and will subside. As dermal fillers for the tear troughs are very fluid and not viscous, the recovery time will be fairly quick.

How often do you need to get a tear trough treatment using dermal fillers?

The longevity of your results somewhat depends on your individual response to dermal fillers and how quickly your body will metabolise the product injected. Some lifestyle factors such as smoking, excessive sun exposure and regular strenuous exercise can impede the longevity of your results and compromise the quality of your skin.

At The Harley Street Face Clinic, we use products that are proven to provide the highest safety records as well as exceptional performance. Most patients will experience results for at least 12 to 18 months.

Is there any downtime or aftercare required with a tear trough treatment using dermal fillers?

You may have a little swelling, some tenderness and slight bruising following your tear trough treatment. However, this will ease in a day or so and will not prevent you undertaking your normal everyday activities.

Aftercare will include avoiding saunas, hot baths, steam or excessive exercise for 24 hours post-procedure, as well as avoiding rubbing or touching the area for at least 48 hours. You may wish to rest on the day of your procedure and will be advised to avoid wearing any makeup for at least 6 hours post-procedure.

What, if any, are the possible side effects of tear trough fillers?

On rare occasions there can be a serious issue with fillers around the eyes, resulting in damaged vision. For this reason, it is important to see a specialist who has knowledge of the underlying anatomy of the face so these problems can be avoided.

At The Harley Street Face Clinic, our practitioners are medically qualified to administer the treatment safely. They take all necessary steps to ensure a good result free of issues.

About the Author

Dr. Julian De Silva is a leading facial plastic surgeon that specialises only in surgical and non-surgical facial procedures. Dr. De Silva has considerable experience in cosmetic and reconstructive facial surgery from fellowships in London, Los Angeles, and New York. He is one of a handful of elite surgeons to be recognised with British, European and American qualifications, memberships and board certification.

Dr Julian De Silva's Google Scholar

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