If you have swelling, in some cases, more volume of the filler is needed to fill the crack. This can lead to stuffing that makes things worse. A common problem seen in clinics is the worsening of malar pockets due to lacrimal canal filling. Fillers tend to cause bloating, so patients with malar bags or festoons should avoid treatment with filler.
The loss of volume in the cheek region can further accentuate the “bags” under the eyes. The eyelid has the thinnest skin on the body, so any superficially placed padding can be seen. Silicone and other permanent fillers can cause immunogenic reactions and lumps or granulomas under the eyes, so they are usually avoided in this delicate area. The right choice of filling, placement and injection technique can reduce this risk and, in certain cases, improve festoons. If dark circles are your biggest concern, tear filler may not be the right treatment for you.
An expert injector may be able to help, but most cases would be better resolved with eye bag removal surgery (blepharoplasty). Hyaluronic acid facial fillers are generally considered to be the safest option for treating the area under the eyes. However, if a facial filler product is placed too shallow on the skin or on top of the muscle layer, it may settle with an abnormal appearance and may appear bulky, swollen, or uneven. Hyaluronidase injections can dissolve facial filler products that cause the Tyndall effect. Complications from improper facial filler injections under the eyes have become more common and can be very noticeable and disturbing in this highly visible area of the face.
Even though HA fillers generally last for shorter periods of time on other areas of the face, they often last much longer in the area under the eyes. People should consult an expert in eyelid rejuvenation to determine if a more definitive surgical option is better suited for their needs.
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