Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 11/3/2021
As you get older, it’s common for fine lines and wrinkles to appear on your face. One area that’s often affected by the aging process is the periorbital hollow — the loose, thin skin that’s beneath your eyes.
Like with other aspects of the aging process, developing some lines around your eyes is largely unavoidable.
However, with a proactive approach to aging, it’s usually possible to minimize the appearance of the under-eye lines, wrinkles and bags that can develop with time.
Enter under-eye fillers. Designed to get rid of eye bags, wrinkles and dark circles, fillers are one of the most effective options for slowing down or reversing the aging process.
However, just like with other skin care treatments, it’s important to understand how they work before getting them.
Below, we’ve explained everything you need to know about under-eye fillers, from filler pricing to how long they last, what you can expect and side effects that you should be aware of before you book a session.
We’ve also shared other ways that you can treat aging that affects your under-eye hollows, from good skin care habits to medications, over-the-counter products and more.
Under-eye fillers are exactly what they sound like — dermal fillers that are applied to the area of skin that’s located under each of your eyes.
This area, which is referred to as the periorbital hollow, is often one of the first parts of the face to become affected by lines and wrinkles, as its thinness and near-constant use in many facial expressions makes it prone to creasing.
Unlike creams, peels and other treatments, which often require months of daily use to produce results, under-eye fillers provide instant improvements in your skin’s texture and appearance.
As you get older, your skin changes. The outermost layer of your skin, called the epidermis, gets thinner.
As you make certain facial expressions again and again, lines and creases start to form in your skin, especially in areas such as your forehead, near your mouth and below your eyes.
Dermal fillers work by adding volume and fullness to your face. This helps to reverse the effects of thinning skin and make the fine lines, wrinkles and contours that can develop on your face as you get older less visible.
Fillers are injected into your skin. In the United States, dermal fillers are normally administered by a healthcare provider trained in injecting filler.
In addition to treating under-eye lines, wrinkles, creases and other signs of aging, dermal fillers can also:
Add volume to thin lips
Soften other facial creases and wrinkles
Reconstruct facial deformities or damaged skin
Make atrophic scars less visible
Enhance other facial contours
Several different types of dermal fillers are available, including fillers made from hyaluronic acid (sold under brand names such as Juvederm®, Restylane®, Captique®, Prevelle, Perlane® and others).
Hyaluronic acid fillers work by increasing the amount of hyaluronic acid in your skin. Hyaluronic acid is a natural substance that’s responsible for keeping your skin hydrated, healthy and giving it a “full” appearance.
Fillers made from hyaluronic acid are versatile and are used to treat everything from acne scars to crow’s feet, worry lines and depressions caused by loss of facial volume.
Other fillers, such as Radiesse®, are made using calcium hydroxylapatite — a substance that’s found in human bones.
Calcium hydroxylapatite fillers are often used to treat skin creases and to enhance the fullness of facial contours.
Other substances used in facial fillers include polyalkylimide (used in Aquamid®), polylactic acid (Sculptra®) and polymethyl-methacrylate microspheres (PMMA), a type of semi-permanent filler that’s used in Bellafill®.
The cost of under-eye fillers can vary based on the type of filler you use and the amount of filler that’s injected into your skin.
Your choice of plastic surgeon or dermatologist may also affect the cost of getting dermal fillers.
According to statistics from the American Society of Plastic Surgeons, you can expect to pay the following per syringe for popular fillers:
For hyaluronic acid fillers, approximately $684 per syringe
For calcium hydroxylapatite fillers, approximately $717 per syringe
For platelet-rich plasma (PRP), approximately $981 per syringe
For polymethyl-methacrylate microspheres, approximately $1,058 per syringe
For polylactic acid, approximately $853 per syringe
For fat grafting, approximately $2,508 per syringe
One thing that’s important to keep in mind with under-eye filler (or filler for any other part of your face, for that matter) is that the procedure needs to be repeated for lasting results.
With the exception of fat grafting, most fillers are eventually absorbed by your body. As such, it’s best to think of the pricing above as the price per syringe, per treatment, rather than as a one-off cost for treating under-eye lines, wrinkles or loss of volume.
We’ve talked about this more in the section below and explained how long you should expect to maintain your results from each type of dermal filler.
Most fillers last for six to 18 months, after which you’ll need to get additional injections in order to maintain your results.
The amount of time that a filler lasts depends on the specific type of filler, as well as how deep the filler is injected into your skin.
Most of the time, filler that’s injected deep into your skin will last longer than more superficial thinner used to fill in shallow contours.
Generally speaking, hyaluronic acid fillers last for between six and 18 months. Fillers that are made using synthetic materials may last for longer — many people find that these fillers last for several years at a time.
Finally, injections that use fat harvested from elsewhere on your body are meant to last forever, although it’s common for some of the fat not to survive for the long term.
Your provider may use slightly more fat than is required in order to provide long-lasting, natural looking results.
Most dermal fillers are safe and effective when injected by a plastic surgeon, dermatologist or other healthcare professional.
The FDA has approved several brands of fillers, including those mentioned earlier.
However, there are some risks, side effects and issues that you should be aware of before you get fillers, especially for the skin under your eyes.
The first is that although fillers are a non-surgical procedure, the actual process of having filler injected can feel somewhat uncomfortable.
To make things less painful, your provider may use numbing cream to reduce sensitivity in the target area before injecting filler into your skin.
The second is that fillers often cause bruising and swelling, especially during the first couple of days after the procedure.
Most people can get back to normal life right away, but your face may have a swollen, unnatural appearance for one to two days after the filler is injected.
The third is that although most fillers are approved by the FDA for facial use, none are currently approved for use in the tear troughs (the area under your eyes).
This means that using filler for the under-eye area is technically an off-label use.
Serious complications from fillers are rare. However, they can happen. Potential complications from fillers, including under-eye fillers, include:
An itchy, uncomfortable skin rash
Redness and swelling
Bacterial infection at the injection site
Damage to your skin, potentially resulting in scarring
Under-eye fillers usually look natural and aesthetically pleasing. However, in some cases, fillers may result in asymmetry, unnatural-looking lumps and overcorrection of fine lines, wrinkles and other signs of aging.
Although it’s very uncommon, dermal fillers can cause blood flow problems when injected into a blood vessel.
In some cases, this can cause necrosis and permanent skin damage. In very rare cases, severe complications may affect your eyesight or cause blindness.
While these complications can sound alarming, it’s important to remember that dermal fillers are given to millions of people every year, with complications uncommon.
Your healthcare provider will inform you about what you need to do to take care of your skin in the days after getting under-eye fillers, as well as what you should avoid to reduce your risk of experiencing complications.
In addition to dermal fillers, there are numerous ways that you can slow down the aging process and improve the appearance of your under-eye areas, or tear troughs.
These include using prescription medications, treating your skin with over-the-counter products and changing your habits so that your skin isn’t damaged by UV radiation, harmful chemicals or other factors that can contribute to the skin aging process.
Tretinoin is a retinoid that’s used to treat acne and skin aging. It works by improving your skin’s ability to produce new skin cells and promoting exfoliation (peeling of dead, leftover cells).You can find tretinoin in our Anti-Aging Cream, which is designed specifically to improve skin texture and lighten the appearance of fine lines and wrinkles.
If you only have mild under-eye lines, you might want to use an over-the-counter retinoid before using tretinoin.
Over-the-counter retinoids are less powerful, but can improve the appearance of mild fine lines and wrinkles.Good over-the-counter retinoids include adapalene and retinol. Both are widely used in serums, anti-aging creams and other skin care products available over the counter from your local drug store.
Fillers aren’t the only procedure that can improve the appearance of your skin. Other cosmetic procedures, such as chemical peeling or microdermabrasion, can also lighten the appearance of under-eye bags, wrinkles and other signs of aging.
Chemical peeling involves removing the damaged layers of your skin using a chemical solution, usually an alpha-hydroxy or beta-hydroxy acid.
Microdermabrasion involves gently sanding away damaged, old skin using a minimally abrasive instrument.
These procedures have the added advantage of treating other areas of your face than just your tear troughs, such as forehead and nasolabial folds.
They can also treat other skin issues, such as acne, hyperpigmentation, stretch marks and scarring.
While some skin aging is an unavoidable result of getting older, a significant amount of aging is environmental, meaning it’s linked to factors that are at least partially within your control.
By far the largest cause of skin aging is photoaging — damage to your skin that’s caused by sun exposure and UV radiation.
In fact, according to the Skin Cancer Association, skin damage due to UV is responsible for 90 percent of visible changes that affect your skin as you get older.
You can minimize UV-related skin damage by limiting your exposure to sunlight, and by keeping your skin protected from UV radiation when you’re outdoors.
The best way to do this is by applying a broad-spectrum, SPF 30+ sunscreen to your skin every time you go outdoors on a sunny day, and by wearing a hat, sunglasses and other clothing that shields your skin from direct sunlight.
If you haven’t yet noticed lines or bags under your eyes, protecting your skin from UV radiation can slow down or prevent them from developing.
If you already have signs of under-eye aging, taking sun protection seriously may help to prevent them from getting worse.
Limiting your sun exposure is especially important if you use anti-aging treatments like tretinoin, as these may make your skin more sensitive to sunlight.
Properly hydrated skin is healthy, youthful skin. Moisturizer helps to keep your skin hydrated by trapping moisture inside it, giving it additional volume and reducing the visibility of fine lines and wrinkles that can develop under your eyes and elsewhere on your face.
In fact, according to the American Academy of Dermatology, moisturizer is one of the two most effective anti-aging products you can use (the other, not surprisingly, is sunscreen).
To get the best results from moisturizer, try to apply it within five minutes of the time you get out of the shower.
This helps to trap the extra moisture inside your skin, giving it some extra volume and minimizing the appearance of wrinkles and eye bags throughout the day.
Smoking not only damages your heart, lungs and other organs — it also takes a serious toll on your skin’s health, texture and appearance.
In a study published in the journal Tanaffos in 2019, researchers compared the skin of smokers and non-smokers to assess the effects of smoking on aging.
They found that the smokers had skin that was less elastic, less dense and more likely to show certain types of indentations.
Another study published in the American Journal of Public Health found that smoking increased the risk of a person developing moderate or severe wrinkles.
While under-eye fillers may help to reverse some of these effects, you’ll get the best results and the most noticeable improvements by quitting smoking.
Our guide to the benefits of quitting smoking goes into more detail about how quitting improves your skin, as well as the other health, lifestyle and financial benefits of quitting.
Under-eye fillers can reduce the visibility of fine lines and wrinkles, enhance your skin’s texture and get rid of the “sunken eyes” look that often develops with time.
If you’re considering an under-eye filler procedure, make sure to have it performed by a trained, licensed professional.
This means visiting a plastic surgeon or dermatologist, not an unlicensed provider at a beauty salon or med spa.
You may also want to consider other facial aging treatment options, such as our science-based Anti-Aging Cream.
Finally, remember that while fillers are effective, they aren’t magic. Make sure to pair your fillers with dermatologist-recommended skin care tips to maintain your results and keep your skin firm, smooth and healthy for the future.