More than ever, our eyes and the area surrounding them have become the center of expression and communication. They can portray vitality and youthfulness, or tiredness and premature aging. Thus, the appearance of the periocular region has grown in significance for men and women alike.

A youthful lower eyelid is characterized by a smooth eyelid-cheek junction, smooth skin, and sufficient cheek volume that supports the lids and creates a natural convexity in the malar area. When the lower lid and cheek area present poor support due to bone absorption, loss of soft tissue volume, or aging, the lower eyelids take on a tired and hollow appearance. This look is characterized by a deep groove adjacent to the nose, also known as tear trough deformity, bags under the eyes, and a flatter cheek contour. In some individuals, especially those with chronic allergies, this condition may also be associated with bluish discoloration of the lower lids, i.e., dark circles.

Options available for achieving lower eyelid rejuvenation.

Several surgical techniques have been designed to restore volume and improve the aesthetics of the lower eyelids. These include surgical blepharoplasty with fat repositioning, fat transfer to the cheek area, and malar implants. Non-surgical lower eyelid rejuvenation is based on the principle that the treatment of these unwanted signs can be accomplished by adding volume to the lid-cheek anatomical unit in an individualized manner. Medical devices, called dermal fillers, are currently used to achieve this goal.

Lower eyelid rejuvenation with dermal fillers

Dermal fillers are gel-like substances injected underneath the skin to provide volume in specific areas of the face. The goal of dermal filler application is to achieve natural, youthful aesthetic improvements in a safe manner. Some fillers have been specifically designed to correct lower eyelid bags and dark circles. In fact, facial plastic surgeons and dermatologists use these products in many patients to achieve lower eyelid rejuvenation without undergoing surgery.

There are several key points to consider when using dermal fillers on the lower eyelids. First, the physician applying the filler must have extensive experience with their application. The lower eyelids are one of the most delicate facial structures and can quickly become damaged if the procedure is done incorrectly. The only way to acquire natural results is by having a good grasp of the area’s anatomy and physiology. The injector must be familiar with the right products and the safest and most effective technique to approach this delicate area.

Choosing a suitable filler is fundamental. Not all fillers have the same quality or are indicated for the lower eyelids. Therefore, the physician must select the filler that best fits his or her patient’s aesthetic needs. The hyaluronic acid family of fillers, for example, is an excellent choice for this area of the face.

Finally, how the injection is administered is likely the most determining factor in the outcome. The application should be made in the doctor’s office in a sterile manner. Topical anesthesia or regional nerve blocks should accompany the procedure to guarantee a painless injection. Most importantly, the physician must be familiar with the anatomy of the periocular region, gently sculpting the anterior and lateral cheek area to provide support for the lid and camouflage the appearance of bags.

What can I expect after filler application under my eyes?

Expect lower eyelid swelling after the application of fillers. This swelling may last up to a week in some patients. Bruising may also occur but is not as common. On the first day, patients should apply cold compresses to the lids but must avoid massaging the area.

Some patients may notice a bluish hue underneath the lower eyelid skin, known as the Tyndall effect. It is more likely to occur in fair-skinned individuals. If this happens, a conservative approach is acceptable, or the filler may be partially dissolved with an enzyme.

Dermal fillers do not offer permanent results.

Correction of lower eyelid bags and dark circles with fillers is NOT a permanent treatment. The result may last anywhere from 6 months to 18 months, depending on the amount of product and the quality of the filler that is applied. Therefore, patients should plan to repeat the application as needed.

Complementing fillers with botulinum toxin for comprehensive lower eyelid rejuvenation.

Botulinum toxin (Botox) serves to relax muscles in the face. The main goal of this product is to treat expression lines and fine wrinkles. However, we are beginning to recognize other effects of this wonderful product, such as a better skin texture and tissue remodeling in the areas where it is injected.

Botox may be applied in the periocular area to improve lid contour and reduce the action of the brow depressor muscles. It is a great way to complement the volumizing effect of dermal fillers. When used together, fillers and Botox work to add to their individual outcomes, thus creating the best aesthetic results.

At ArteFacial, we are committed to offering our patients the best non-surgical alternatives to improve lower lid appearance by providing natural results with the finest products.


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