As fillers attract water, it can cause swelling under the eyes where the solution is placed too close to the surface. The choice of filling product should also be carefully selected, as there are different types and they vary in the amount of water they attract and, therefore, in the potential they have to cause swelling. Some eye bags are caused by a true vacuum under the eye, which can be treated by filling the slit with dermal fillers. However, other types of eye bags are caused by fat pads that are too large.
In these cases, fillers are definitely the wrong treatment. Tear canals are a complex area to treat and should only be tried by experienced injectors. When done correctly, dermal filling in the tear canal can reduce the appearance of fatigue under the eyes and improve the sagging effect that occurs as we age. Treatment of lacrimal canals should only be performed by experienced professionals. As you will see, problems can occur as a result of poor choice of filling, a lack of understanding of the patient's anatomy, or poor patient selection.
Using facial fillers in general, with no experience in facial anatomy, can cause an irregular appearance. The photo shown here was discussed by the International Academy of Cosmetic Dermatology and shows a patient in her 50s who has been overtreated with dermal filler. Despite how hard it is to hear, overfilled tear canals don't look good and it's best to dissolve the filling and re-build the area using less product. Sometimes, too much facial filler product may have been placed in the recesses of the lower eyelid, creating an overfilling effect that can make the area look more puffy. Dermal fillers have been approved by the FDA for use only on the cheeks, lips, nasolabial folds, and hands, but doctors often use injectables in ways not indicated on the label.
If you have an area of your lower eyelid that appears to have the Tyndall effect, hyaluronidase injections will usually correct the problem by dissolving the facial filler product. In the past year, I have seen an increase in patients coming to me from all over the world for my eyelid rejuvenation techniques who need to dissolve misplaced fillers. The main reason for getting under-eye fillers is to fill a hole under the eye colloquially called a tear canal, says Noelani Gonzalez, MD, a board-certified dermatologist and director of cosmetic dermatology at Mount Sinai West. In essence, although fillers may be an option when dealing with an expert injector, most cases would benefit best if an expert in eyelid rejuvenation evaluated the situation and considered a more definitive surgical option to correct the problem instead of trying to hide it with fillers. Dermal filler can be used under the eyes in patients with dark circles; placing it in the tear canal can change how light reflects on skin and reduce darkness.
Additionally, lighter skin tones may experience something known as Tyndall effect when hyaluronic acid fillers are injected into superficial dermis or epidermis. The under-eye filler isn't as noticeable as other types (think lips or cheeks), so I didn't expect it to like it as much as I did. Although complications with facial filler injections under eyes (tear rejuvenation) are rare in general; unfortunately they can occur even if injection was performed by qualified and skilled injector due to delicate and complex anatomy around eyes. Not all injectors that can take syringe and perform facial filler injections are qualified with specific knowledge and advanced technical expertise necessary to perform this procedure properly and effectively. If your dark circles are actually caused by darker pigment in your skin, filler will only accentuate them. Fortunately this can be treated with injection of hyaluronidase - an enzyme that breaks down hyaluronic acid in filler.
Most commonly used fillers are made of hyaluronic acid and can create volume and definition as well as fresh moist finish.
