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4 Different Types of Fillers for Under the Eyes

Here are the four different types of fillers under the eyes along with in-depth and comprehensive description of each one to help you understand the procedure and its side-effects.

A woman having under eye fillers procedure.

Signs of aging are never an easy thing to accept, and many people are willing to do whatever they can to age gracefully and retain their youthful look. With advanced medicine, there are a number of options to choose from to make your eyes look bright again.

Eye fillers make the under-eye area look fuller and restore its brightness. There are a number of options to choose from, each has its own sets of advantages and costs. A licensed and reputable plastic surgeon can break down your options and help guide your decision.

Going into your appointment with an idea of how much you’d like to spend as well as which treatment you’d prefer is a good starting point. You should also take into account how much recovery time you’ll require and what side effects each filler could have.

Hyaluronic Acid

This is a screenshot of the Juvederm homepage.

Source: Juvederm

Hyaluronic Acid fillers are one of the more popular options of fillers on the market. It is less likely to clump and easier to smooth out during its application. It’s more natural-looking and lasts 9-12 months before you may require a touch-up procedure but can also last longer.

It is more freely available and the results are nearly instant. The most common brands of the hyaluronic acid eye are Juvederm, Belotero, and Restylane. All of these brands are FDA-approved and safe to use.

Juvederm has lidocaine inside the injection which contributes to the pain reduction of the injected area directly after the treatment.

Procedures using hyaluronic acid filler typically take between 15 – 60 minutes to perform.

Hyaluronic acid naturally occurs in the skin and the filler makes use of a synthetic gel that mimics the naturally produced substance. It is a more natural-looking filler and plumps up the under-eye area.  

It takes the shortest amount of time for hyaluronic acid to have results out of all fillers. These fillers work by adding volume to facial tissues that may have experienced some damage over the years or for people who would like to add volume to areas they feel need to be plumped up.  

Common side effects often include bruising around the area, redness, and swelling. These are likely to appear within a few hours of treatment and should not be present for longer than a week or two while the area heals.

More serious complications can include lumps forming under the eye, blindness, scarring, and nerve paralysis. These complications are extraordinarily rare and can be minimized by choosing a reputable professional.

Another rare side effect is the Tyndall effect. This is when hyaluronic fillers are inserted too close to the skin’s surface and create a bluish effect. It can cause the area to become puffy and the skin may even tear.

In this instance, the filler needs to be dissolved.

Hyaluronic fillers are safe and rarely result in extreme side effects. They are easily administered by a number of registered technicians and doctors. These are the most popular type of fillers.

Poly-L-lactic Acid

This is a screenshot of the Sculptra homepage.

Source: Sculptra

Poly-L-latic Acid is administered using a linear threading technique which ensures that the filler is evenly spread across the area. Linear threading is a technique whereby the needle is inserted in the center of the area, for example, the under eye, and the needle is slowly withdrawn while the product is deposited in the creases.

It has been FDA-approved for use to restore the facial fat loss. It is a safe procedure and often lasts longer than Hydrochloric Acid but it is thicker than Hydrochloric Acid and can become lumpy under the skin.

This is why it is important for the administrator to ensure that it is evenly spread and correctly administered.

A common brand of Poly-L-lactic acid is Sculptra, which is FDA approved. It requires no special preparation or pretesting and is administered by a professional in-office. Results can be seen after one treatment but the average treatment is administered over 3 to 4 months.

Common side effects of Poly-L-Lactic Acid include swelling, signs of bruising around the injection site, bleeding, redness where the filler was inserted, and possibly lumps.

More rare side effects, that could have more serious implications, are allergic reactions, scarring, an infection if the area is not correctly prepared and looked after, possible blindness, blisters, and in some cases the filler could migrate to other areas.

It is possible for numbness in the area to occur, and for inflammation to appear. These are both rare reactions but it is important to keep them in mind.

Poly-L-Lactic Acid is not as often used for under-eye fillers as it is not ideal for use close to the eye. It is also not ideal for those with uncontrolled diabetes, blood clotting issues, connective tissue disorders, or woman who are pregnant or breastfeeding.

It is however a safe option, and a professional will best make the decision if Poly-L-Lactic acid fillers are suitable for you.

Calcium Hydroxylapatite

This is a screenshot of the Radiesse homepage.

Source: Radiesse

Calcium Hydroxylapatite is marketed as Radiesse and is noted to be hypoallergic and non-toxic. It is a convenient treatment that can be administered in the office of a certified professional.

Its common side effects that you can be expected include pain in the injection side, some itching around the area, swelling, bruising, or redness. More serious side effects can include infection and nodules that can form on the back of your hand or underneath your eye that need to be surgically removed or require steroid treatments.

Other more serious complications can occur if the injection is placed into a blood vessel which can cause some temporary or permanent side effects. This is quite rare but should be discussed with your therapist.

In some cases, the under-eye area can become a white color due to the administration of the filler.

The treatment session typically lasts around 15 minutes and does not require you to rest although it is a good idea not to do any strenuous activities for a day or two as well as any sunlight exposure.

Radiesse is a common choice for facial treatments and its effects last for around two years. The results can be seen immediately. The costs will vary depending on how many treatments you require and the dosage per treatment.

It is important to go to a registered technician or plastic surgeon who will be able to assist you. They will be able to advise you as to how many treatments you will require.

Interestingly Radiesse gained popularity as it was approved to help those suffering from HIV who had lost facial volume.

It is made up of phosphates and calcium which already naturally occur in the body and further stimulate collagen production in your body.

Calcium Hydroxylapatite is thicker than Hydrochloric Acid and is commonly diluted with aesthetic before it is administered. Lidocaine is often used to reduce the pain of the injection but it is up to you whether you would like it to be used.

Calcium Hydroxylapatite is a safe product and easily available.

Fat Transfer

This is a fat filler procedure infographic.

Another method of eye filler that your doctor may recommend is a fat transfer. This makes use of the fat on other parts of your body – such as the fat found in your abdomen, your buttocks, your inner thighs, and your hips.

Fat transfers are often a preferred option as patients would like to have a natural substance in their body, however other fillers do make use of substances that already occur within your body.

It is also believed that fat transfers are better for you as your body is less likely to reject a substance from itself.

Fat transfers are not ideal as fat requires a constant blood supply to remain alive and should only be completed under the advice of a skilled doctor. A fat transfer is more complicated than other under-eye fillers as it requires liposuction to remove the fat from your body.

If the fat transfer does not take correctly, it could take a number of corrective surgeries to fix the appearance of the area. Fat transfers can cost significantly more than other fillers and are more time-consuming.

You will need to spend some time recovering from the liposuction and the procedure takes about an hour on average.

It is a great option as it is a more permanent solution and has been known to have longer lasting effects. In many cases, its effects have been noticed for four years after the procedure.

If done correctly, a fat transfer is a natural-looking filler that corrects the sunken-in appearance of your undereye.

Common side effects of a fat transfer is that it may appear lumpy and is often difficult to control. You will experience some pain where the fat was harvested and where the fat is injected into.

Bruising and swell are also both common side effects, as with any filler.

It is vital that you keep the areas of treatment clean and follow all aftercare instructions.

A registered plastic surgeon with being required to perform this operation. You will need a consultation beforehand in order to determine if you will be a good candidate for a fat transfer.

It is still a popular procedure as people prefer to have natural substances in their bodies, but the risks must first be evaluated and discussed with your doctor.

What is the Procedure Like?

A woman having under eye fillers procedure.

Depending on which filler you and your chosen technician decide to proceed with, the procedure may differ slightly. They will advise you how the appointment will go on the day. However, on average you can expect the below.

Before you arrive at your appointment, your doctor or registered technician would have likely asked you to prepare for your appointment. It is best to eat beforehand and have some water on you.

Although the technician will disinfect the injection site, it is highly recommended that you wash your face before your appointment to ensure that the area is 100% clean. This will reduce the chance of infection.

If you have had a consultation with your therapist beforehand, then they will have already discussed with you where it would be best to administer the treatment.

When your appointment begins, the site will first be sterilized, and then a numbing cream will be applied, in some instances, you can be injected with a local anesthetic or lidocaine.  Your technician will then mark up the area where the treatment will be administered.

The most common method for eye fillers to be administered is the linear/threading technique. This is where the needle is placed into the center of the area and is slowly withdrawn while the treatment is deposited along the area.

Once the filler has been injected underneath the eye, the technician will smooth it out and ensure that there are no lumps. This is vital as some fillers are thicker than others and more prone to becoming lumpy if not correctly administered.

Once the treatment is complete, you should be able to return to your normal activities. However, it is best that you avoid any strenuous activities and exposure to sunlight. You should ensure that the area is kept clean in order to avoid infections.

Your technician will provide you with detailed aftercare instructions, it is important that you follow these carefully.

With the correct care, your fillers can last a number of years. You will likely need to have touch-ups done on the area every few years to ensure you remain to look vibrant.

If you are unhappy with your filler, it is possible to dissolve it but should only be done by a registered technician or doctor. Fat transfers are however more complicated to correct.

Enjoy your new youthful appearance!

In Conclusion

It is extremely important to do research on well-respected professionals in your area, and which filler would be best suited for you. A consultation will help you decide which product would be best suited to you, and help you decide on the professional to administer the treatment.

There are a number of types of fillers for you to choose from that will best suit your budget, recovery time, and the effect you are hoping to achieve. Each filler lasts for a different length of time and will require touch-ups.

Taking your time to make this decision will be to your benefit and help you achieve the look you are hoping for.


Healthline: Sculptra

Healthline: Radiesse

Youtube: Prasad Cosmetic Surgery: Potential Complications of Fat Grafting Under the Eyes

Healthline: Eye Fillers Side Effects

Reuters: US Fat Eyes

ASDS: Injectable Poly-L-Lactic Acid

Wo-Med: Injection Technique