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Dermal Fillers: Under Eye Treatment
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“I don’t want to look tired”

This is the most common request an oculoplastic surgeon hears from patients who come in for an under-eye filler injection. Under eye circles, or hollows can give the appearance of constantly being tired or even appearing older. This under eye area appearing darker or hollow is a common cosmetic concern. A non-surgical technique to correct this condition is injecting using dermal fillers. In many cases, the appearance of these tear troughs is genetic rather than a result of ageing, and often appear early on even in teenage years.


This under eye hollow – also known as ‘tear trough deformity’ when filled with dermal fillers effectively smoothen the eyebags and create a smooth transition between the lower lid and the cheek giving a youthful energized look.


Dr. Akshay Nair, Oculoplastic Surgeon has considerable experience in performing facial filler injections. Undereye fillers is not something that is seen only in ‘older’ people. Some of our happy patients have been as young as 20 years old and are very satisfied with the outcomes.

What is a dermal filler?

Dermal fillers are gel-like substances which are injected beneath the skin. These fillers add to the lost volume on the face; they also help to smoothen some wrinkled and lines and soften creases. Fillers also can enhance facial contour. The most commonly used filler, especially in the under-eye area is hyaluronic acid gel. This is available as different brands – Belotero and Juvederm among others.

Slide this image to see the subtle, natural yet amazing difference that a dermal filler injection to the under eye are can do your face and your eyes!

Is it painful?

Prior to administering a dermal filler, a local anesthetic ointment is applied over the area to be treated. Waiting for about 15-25 minutes with the anesthetic cream makes the procedure pain-free and comfortable. In addition, many dermal filler products such as Juvederm™ or Belotero™ come with a local anesthetic – lidocaine pre-mixed in the syringe. This is also known to make the procedure even more pain-free. Most patients report little to no pain during the entire process.

How long does the procedure take?

Typically, at our clinic, a consultation with Dr. Akshay Nair takes about 25-30 minutes where all your questions will be answered and as previously mentioned, there is a 20-25-minute waiting period with the numbing cream applied. The procedure of the dermal filler itself takes about 15 minutes. So, one must allow for at least an hour in the clinic, while planning for an under-eye filler injection.

How long does it last?

Tear troughs are the hollows between the lower eyelid and the cheeks. Alternately, the appearance of tear trough grooves can occur because of volume loss around the cheek and therefore loss of support of the lower lid. The dermal fillers – most commonly hyaluronic acid gel, are injected under the eye and this hyaluronic acid gel should last anywhere between 8 to 15 months, depending on how quickly the body metabolizes it and also the type of filler used (Restylane, Restylane Lift, Juvederm, Belotero etc.). The gel gradually dissolves slowly over time. In case, a patient needs to dissolve the filler quickly after the procedure for any reason, hyaluronidase, an enzyme can be used – this enzyme breaks down hyaluronic acid fillers.

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How long is the recovery after a filler injection?

Like any treatment, be sure your specialist is trained to inject filler injection with adequate experience in injections under the eye. The under-eye filler has to be placed deep, not superficially, so it doesn't appear superficial or bulging. People with a fair complexion may bruise and this bruising should subside in about a week or two. Dr. Akshay G. Nair is a fellowship trained oculoplastic surgeon who is specialized in cosmetic treatments and surgeries around the eye with many years of experience.

Planning a filler injection ? Questions or queries - send an email to for detailed answers to all your doubts. 
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