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Fillers for Lower Eye Bags & Dark Circles

Fillers are a minimally invasive facial treatment that have really changed the way we temporarily treat lower eyelid bags and dark circles. Since I started my practice more than 10 years ago I’ve seen a significant change in how we treat these problems. I’ve done thousands of fillers for lower eyelids and these are some of the most important things I’d like you to know before you let anyone inject anything around your eyes.

  1. Who is qualified to inject my lower eyelids and why do I need to see a specialist?
  2. What are different types of fillers and what are the best to use around the eyes?
  3. How long do most hyaluronic acid fillers such as Belotero and Restylane last around the eyes?
  4. Can my own fat be used as a filler?
  5. Who is a candidate and who is not?
  6. How is the procedure performed?
  7. Why do you use a blunt needle rather than a sharp one to inject the fillers?
  8. Chronic fluid retention syndrome, also known as chronic eyelid swelling, after fillers?
  9. What is the Tyndall effect after fillers and how can it be treated?
  10. Can fillers affect future surgeries?
  11. What are the costs of filler injection around the eyes?
  12. OK I want to know if I’m a candidate, how should I proceed?

1. Who is qualified to inject my lower eyelids and why do I need to see a specialist?

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This is probably one of the most important questions you need to ask yourself when it comes to your eyelids. The tissue around the eyes is very delicate. What amazes me is that today we have many different “injectors” who are nurses, dentists, physician assistants, family physicians, dermatologists and even general plastic surgeons who take a weekend course and, without understanding the delicate eyelid and periocular anatomy, start injecting patients. This may sound OK to you but we are seeing an epidemic of problems occurring that didn’t exist before. These problems happen because 1. the wrong product was injected, 2. the right product was injected to the wrong place, 3. the wrong patient was selected for the injection. The person who should inject you should be an expert in the eyelids. Start by looking for an oculoplastic surgeon who does a lot of cosmetic eyelid procedures and has experience with injectables.

2. What are different types of fillers and what are the best to use around the eyes?

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As we age we lose volume around our face and soft tissue around our eyes. Think of a grape that shrivels with time. Fillers replace the volume in the soft tissue. The hyalauronic acid family of fillers such as Restylane and Belotero are my two favorite minimally invasive procedures. In general, I do not recommend injecting Juvederm products around the eyes as they are very hydrophilic (love water) and this causes a lot of chronic swelling.

3. How long do most hyaluronic acid fillers such as Belotero and Restylane last around the eyes?

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I would say on average most HA fillers last about 1 to 1.5 years. But I have seen cases where they last much longer.

4. Can my own fat be used as a filler?

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Yes, if a patient is having eyelid surgery with me and they have more than 20% volume loss around the face (which is basically anyone over the age of 50), I usually liposuction a small amount of fat from the belly and reinject the fat into the face with small blunt cannulas. This procedure requires anesthesia and is only recommended for patients who are interested in a longer term surgical solution.

5. Who is a candidate and who is not?

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First of all, again it must be clear that fillers are only a temporary solution to lower eyelid bags and dark circles. An oculoplastic surgeon specializing in cosmetic eyelid procedures should be able to tell if you are a candidate for fillers. Typically, patients who have more volume loss (hollowness) around the tear trough are better candidates. If you have puffy lower eyelids, then you are not a candidate for fillers as this will make the puffy eyelids worse. This includes patients who have chronic allergies in their eyes. Unfortunately, I’m seeing a lot of patients that are not the right candidate getting fillers which makes the whole situation worse.

6. How is the procedure performed?

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The skin around the eyelid is numbed using a cream for about 10 to 15 minutes. The area is then cleaned with alcohol. The filler is injected using a blunt needle.

7. Why do you use a blunt needle rather than a sharp one to inject the fillers?

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In my experience the best and safest needle to inject around the eyes is a blunt needle. There are a few reasons for this. 1. reduced risk of bruising, 2. reduced pain, and 3. better anatomical contouring and product placement.

8. Chronic fluid retention syndrome, also known as chronic eyelid swelling, after fillers?

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This is becoming one of the biggest reasons I’m seeing unhappy patients for consults these days. This condition happens when either the wrong filler is injected by an unqualified physician to a patient who doesn’t need fillers or too much is injected. Most of these patients complain of having episodes of on and off swelling of the eyelids. The only way to treat these patients is to get rid of the filler. Typically, these patients need several injections of Hyaluronidase, which helps dissolve the product, separated by two or three weeks. As you can imagine the deflated skin now needs to be tightened either by surgery, co2 laser resurfacing or radiofrequency. Most patients are happy to just get rid of the fillers.

9. What is the Tyndall effect after fillers and how can it be treated?

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The Tyndall effect, also known as Tyndall scattering, is light scattering by particles in a very fine suspension such as a filler. These patients complain of a light blueish color on the superficial skin where the filler was injected. Typically, patients who have very thin skin or have had the filler injected too superficially can get the Tyndall effect. In some cases, the condition resolves by itself as the body absorbs the product. However, in cases that it doesn’t, I recommend removing the product.

10. Can fillers affect future surgeries?

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Most fillers don’t last more than a year, so in theory they don’t really cause problems with surgery; however, I’m seeing patients who have had Juviderm fillers placed around the eyes and if they are not removed prior to surgery they can cause severe post-operative swelling.

11. What are the costs of filler injection around the eyes?

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The cost depends on the type of filler used. The price for HA fillers around the eyes is between $800 to $1500 per syringe.

12. OK I want to know if I’m a candidate, how should I proceed?

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Please contact our office at (310) 777-8880 or contact us for your appointment. We look forward to seeing you soon.

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What Dr. Parsa's Patients Say

4.8 / 5.0

Based on 29 reviews

Erica D.

Dr. Parsa is not only an amazing surgeon! He is also very caring and meticulous! His expertise shows in his wonderful bedside manner overall knowledge of his field. I appreciate his knowledge, advice and professionalism for over 6 years. I trust him with my eyes and refers him to my family and friends! His staff is trusting and caring and I love seeing them!

Sophia P.

Words cannot express how thankful and appreciative I am to have found you. I am deeply grateful for you, for your generosity and caring nature as pertaining to my medical condition. As you know, I was apprehensive about having further surgery, but you are and have been reassuring and confident in the type of procedure you would perform in order to fix my eyelid from the beginning. The fact that you are not pushy and gave me the time and space to make the decision on my own allowed me to prepare myself mentally and emotionally, that really made a difference. Besides from that, your continuous generosity made me confident that you were the right doctor for the task at hand. You will never know how appreciative I am of that. I would also like to let you know how pleased I am with the results of the surgery. I have not felt this comfortable in years. My parents are also very grateful since this was my 14th surgery. You have a true gift. Thank you again for your patience, time, concern, and overall care. I pray that God continues to give you strength to help people who truly need life-changing medical procedures.

Todd H.

Dr. Parsa is an amazing doctor. Warm and very caring. I had my eyes done a couple years ago and I couldn’t be happier. Dr. Parsa likes to take the conservative approach which I greatly appreciate in a doctor when it comes to cosmetic surgery. I also go to Dr. Parsa for Botox and he always knows just the right amount.
The staff in Dr. Parsa’s office are all terrific!

Yuliya O.

I found Dr. Kami Parsa on RealSelf a couple of years ago. He was one of the top doctors I found. I read many of the reviews patients left and they were all great. So, I decided to go ahead and set up a consultation with Dr. Parsa. He is very smart and truly knows what he is talking about. After consulting with a couple of other doctors, I knew Dr. Parsa was the one. I chose Dr. Parsa to perform the surgery. I had a great expericence with the surgery it’s self, everything went very well. I am so happy with the final results. I would 100% recommend Dr. Parsa to anyone who is looking for a upper/ lower Blepharoplasty doctor. Dr. Parsa really knows what he is doing.

Allan B.

I have been bothered for years by my left eye feeling “tired”, manifesting in a a “droop”. My ophthalmologist diagnosed it as “ptosis” (drooping eyelid), and referred me to Dr Parsa for a consult. From the beginning, my experience has been exemplary. First, his assistant, Marie, is amazing-warm, compassionate, knowledgeable. After a comprehensive examination and paying close attention to my explanation of what I have been experiencing, Dr Parsa concluded I am NOT a candidate for the ptosis surgery. Rather, a corrective procedure is actually an eyebrow lift-much simpler, less invasive, far less costly. What a breath of fresh air to find a doctor who is is patient- centered and willing to not “sell” a more expensive job. His professionalism and apparent expertise were evident throughout. This is what healthcare in America should be all about.

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