Dermal filler
Under-eye treatment
This is the treatment we turn people down for most often, and this page is written accordingly.
The skin under the eye is the thinnest on the body and drains fluid poorly. Done well, in the right patient, it makes a genuine difference to a hollow that makes you look tired. Done in the wrong patient, it produces a puffiness that can last months and is harder to fix than the problem you started with.
Who it suits — and who it does not
It suits a true hollow: a shadow caused by volume loss where the lower lid meets the cheek.
It does not suit true fat herniation — the bag that needs surgery rather than filler; significant skin laxity; anyone who already retains fluid or wakes up puffy; thyroid eye disease; kidney problems; very thin, translucent skin; and anyone unwilling to accept the possibility of months of swelling.
If that is you, we will say so at consultation. The consultation is free, and no is a legitimate outcome.
Numbers most clinics do not publish
- Malar oedema — fluid over the cheekbone lasting a month or more: reported in 11% to 25% of patients. One series found almost a quarter developed it, lasting an average of 5.4 months.
- Short-term swelling with a cannula: around 51%. Delayed or longer-term swelling: around 19%.
- In one prospective study: tenderness 67%, swelling 62%, bruising 52%.
- Tyndall effect — a bluish-grey tinge from product placed too superficially. It is reversible, but it can persist for as long as the filler is there, which may be years.
Volume and technique
0.5ml to 1ml in total for both sides, and frequently less. Placed deep, on the bone. Under-treating and reviewing is the correct approach here. If anyone offers to fill your under-eyes generously in one sitting, leave.
Downtime
One to two weeks of unpredictable swelling, and a meaningful minority swell for months. Bruising in around half of patients — and under-eye bruising is hard to conceal.
Risk
The arteries here are direct tributaries of the artery supplying the eye. Read the full risk information before you consent.
Book an appointment
If you know what you want, book it. If you would rather talk it through first, a consultation is free — thirty minutes, no obligation, and the £15 deposit comes back to you when you attend.