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Under-Eye Fillers: Who Are They Suitable For, and What Are the Risks?

Content owner/Author: Specialist Dr. Utkan Kızıltaç — Dermatology Specialist

Last medical review and update: September 10, 2026

What is under-eye filler?

Under-eye filler is an injection procedure performed to reduce the tear trough depression between the lower eyelid and the cheek. Hyaluronic acid fillers are most commonly used.

Who might be suitable candidates?

Individuals with significant anatomical depressions, limited bagging, no advanced skin laxity, and a low tendency for persistent edema may be more suitable candidates.

Does it completely eliminate dark circles under the eyes?

No. It can reduce shadowing caused by sunken areas; however, it does not directly treat pigment or vascular-related darkening.

Who might it not be suitable for?

Fillers may not be a suitable option for individuals with significant puffiness, advanced skin laxity, persistent under-eye edema, or significant lymphatic drainage problems.

How long does it last?

The duration of the effect varies depending on the product and the individual. Hyaluronic acid fillers in the under-eye area may last longer than expected in some people. Therefore, it is important to avoid repeated high-volume applications.

What is the Tyndall effect?

This is the appearance of a bluish or grayish tint under the eyes due to filler being placed too superficially.

What are the risks?

Swelling, bruising, irregularities, persistent edema, and Tyndall's effect may occur. Very rare but serious complications include vascular occlusion and vascular complications affecting vision.

Can it be melted?

Hyaluronic acid fillers can be reduced or dissolved with the hyaluronidase enzyme if necessary.

When is an urgent assessment needed?

Symptoms such as severe pain, sudden pallor or web-like discoloration of the skin, and changes in vision require immediate evaluation.

Dermatologist's Note

When considering under-eye fillers, the first question shouldn't be "which product should we use?", but rather "does this patient really need fillers?". Patient selection, anatomy, and conservative volume planning are fundamental elements in terms of safety and naturalness.

Scientific Resources

1. Trinh LN, Grond SE, Gupta A. Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. Facial Plast Surg. 2022;38(3):228–239. PMID: 34192769. https://pubmed.ncbi.nlm.nih.gov/34192769/

2. Trinh LN, McGuigan KC, Gupta A. Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review. Facial Plast Surg. 2022;38(3):250–259. PMID: 34666405. https://pubmed.ncbi.nlm.nih.gov/34666405/

3. Nalcı Baytaroğlu H, Hoşal MB. Complications of Periorbital Cosmetic Hyaluronic Acid Filler Injections: A Major Review. Turk J Ophthalmol. 2025;55(5):276–286. PMID: 40963300. https://pubmed.ncbi.nlm.nih.gov/40963300/

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