What to Know About Injectables In the Eye Area

According to experts.

What to Know About Injectables in the Eye Area

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When it comes to severe under-eye bags and dark circles, sometimes your trusty eye cream might not cut it. So if you’re looking for a more semi-permanent solution for these skin concerns, that’s where under-eye filler can come in handy. 

Filler in general is a popular aesthetic treatment that targets many skin concerns, such as loss of volume and fine lines. For the eye area in particular, filler can do wonders in brightening the skin and making you look more awake. But as with any injectable, there are a few things to note before you call your dermatologist and commit to a treatment. What exactly are you putting into your face? How long do results last? How painful will it be? The experts break down everything you ever wanted to know about injectables in the eye area. Read on below to see what they had to say. 

What is under-eye filler?

Board-Certified Cosmetic Dermatologist and Mohs Surgeon at the Shafer Clinic Fifth Avenue Dendy Engelman, MD, describes under-eye filler as a gel-like solution that is made of hyaluronic acid. She says it is injected into the skin in the tear trough area and around the eyes to add subtle volume, lift the skin, and minimize dark circles, fine lines, and wrinkles. There are many types of filler and you can pick from many brands, including JUVERDERM, Volbella, and Belotero. Just be sure consult with your physician to see which one is right for you before taking the plunge. 

What are the benefits?

As mentioned before, under-eye filler’s main benefits are to smooth out fine lines and wrinkles and add volume. Dr. Engelman says that it can also reduce the appearance of dark circles and brighten the eye area for a more youthful-looking appearance. These benefits can last anywhere from six to 18 months. 

Under-Eye Filler vs. Botox

While both under-eye filler and botox are injectables that have similar results, they’re different classes of treatment. Board-Certified Dermatologist and Founder of Tone Dermatology Caroline Robinson, MD, explains that Botox is the brand name for a type of neurotoxin and it is a purified liquid protein that relaxes the muscles that pull on the skin. This results in softened and smoother expressions on the skin. You can typically expect to see results from Botox in as little as 72 hours that last for up to three months. 

Filler, on the other hand, does not impact muscle movement. The MD says it is used to fill space to sculpt and contour the cheeks and jawline or smooth the under-eye area. 

Downsides of Eye Injectables

Under-eye filler treatments are relatively safe when they are done by a trained professional, such as a board-certified dermatologist or cosmetic surgeon. Dr. Robinson explains that seeking a professional that has experience injecting in this sensitive area and a deep understanding of the anatomy of the eye will decrease any chance of major risks. She also says that your dermatologist will oftentimes medically screen you to determine if this is the right injectable for you. For example, if you have a medical condition that affects the eye area or are pregnant, she says you should not get this filler treatment. 

When you do get filler injected, she lists redness, swelling, bruising, tenderness, lumps, and bumps as some potential side effects. But those usually go away on their own in a few days (a week max). 

While this is a rare complication, she adds that when filler takes up space around or within a blood vessel, it can lead to a decrease in blood flow to certain areas around the skin and result to the death of skin tissue. If the under-eye filler has not been injected properly, Dr. Engelman says that side effects can be more severe. These can range from nerve damage to blindness, which is why she stresses the importance of seeking a well-trained professional when getting treatment. 

Are eye area injectables painful?

Dr. Engelman says you’ll experience minimal discomfort or pain. She explains that most fillers are pre-mixed with lidocaine and that the initial needle prick can be numbed so that you’ll only feel a light pinch. 

Compared to Botox, she says that under-eye filler causes about the same level of discomfort. She even says that in some causes, filler might be a bit more uncomfortable because the size of the needle is slightly bigger. There might also be some discomfort from the swelling and bruising post-injection, but that’s all dependent on how well you can take injection pain. 

“Because all injection areas are numbed prior to the procedure, the sensation is similar regardless of the injection site,” she says. “I find that a patient’s personal pain tolerance and overall comfort level with the procedure plays more of a role [in how painful the treatment can be].” 

What can I expect during treatment?

There’s important prep that goes on even before getting injected. Dr. Robinson likes to meet with patients before injecting anything and has them tweak their routines up to two weeks before treatment. “A consultation is essential before under-eye filler procedures and before any injectable procedure,” she says. “Because there are several different factors that can contribute to the appearance of the under-eye, it is especially important to understand what factors are impacting you and how filler can potentially address some over all of these.” 

After going over what the reasons could be for changes under the eye area, she then modifies patients’ skincare routines and medications. She recommends patients stop using over-the-counter medications that are not directed by a physician as those can increase the risk of bleeding and bruising. These can include aspirin, ibuprofen, and supplements like vitamin E. For any medication that you have been prescribed, she says consult with your physician before booking a filler appointment. 

Dr. Engelman agrees and adds that likes to tell her patients to avoid alcohol, fish oil, or any other blood-thinning substances prior their appointment. If you’re concerned about bruising, she said you can take oral and topical arnica to mitigate that.  

For the injection itself, Dr. Robinson says that she has patients remove makeup and skincare before she goes in with an anti-bacterial solution. Then the physician will inject the filler with a blunt-tip needling called a cannula into the tear through and under-eye area. She explains that because this type of needle is not that sharp, it is fairly comfortable. While topical numbing product is not needed, she says it can be an option for you if you’re particularly sensitive to pain. 

How much filler will I need?

How much filler you need is dependent on your specific needs. “To see improvement really depends on the anatomy of your eye and how advanced the changes in this area are,” Dr. Robinson explains. “I believe that the under-eye area is one of the most complex areas to correct cosmetically and for that reason I often recommend multiple treatment modalities to help people achieve the most natural-looking improvement.”

Dr. Engelman adds physicians will also take your facial structure and the results you’re hoping to achieve into consideration. But on average she says that most patients only really needs one to two syringes for optimal results. 

What is aftercare like? 

Dr. Engelman advises patients to avoid facial and body massages for up to 48 hours post-injection as there’s a risk that the filler could drift and settle in an undesirable area. 

She also recommends avoiding alcohol or taking blood thinners to reduce the chances of more swelling and bruising. If you are prescribed a medication that thins the blood or makes you more susceptible to swelling or bruising, she says to consult your physician before getting filler treatment. 


While cost for under-eye filler treatments will vary depending on your provider and where you live, it is one of the pricier injectables out there. Dr. Robinson says that the average cost for treatment can be anywhwere from $600 to $1000. But at some clinics, such as Engelman’s Shafer Clinic Fifth Avenue, charge by syringe and those can range anywhere from $1000 to $1400. 

So if you are intrigued by this filler treatment and can afford it, it’s definitely an option to try. Minimal risk (when done by a trained professional of course) and the stunning results just can’t be beat. 

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