Under-eye hollows, dark circles, bags and swelling are different concerns. Before planning tear trough filler, the cause of the appearance must be assessed. This page explains when hyaluronic acid filler may be suitable, its limitations, aftercare and serious complications.
What is under-eye filler?
Under-eye filler is an injectable treatment intended to reduce the groove and volume deficiency between the lower eyelid and cheek. This groove is also called the tear trough. Temporary fillers containing hyaluronic acid are generally used.
The expression “light filler” is sometimes used to describe reducing the shadows caused by hollowing. The treatment does not emit light and does not remove every dark circle, fine line or under-eye bag.
How do hollows, dark circles, bags and swelling differ?
Hollowing is a volume or contour concern related to the underlying bone and soft tissues. It may be an inherited feature in younger people or become more noticeable with ageing. In suitable patients, filler may soften the shadow at the eyelid–cheek junction.
Dark circles can have several causes, including pigmentation, visible vessels beneath thin skin, skin characteristics and shadows. Filler does not remove pigment. A colour difference may remain even when the hollow improves.
Under-eye bags often involve prominent fat, whereas oedema involves fluid retention. With significant excess skin, bags, morning swelling or raised cheek areas called festoons, filler may make the area look puffier. New or one-sided swelling should first be assessed for its cause.
Who may or may not be suitable for under-eye filler?
Adults with limited hollowing, adequate skin support and no marked bags or tendency to swelling may be assessed for filler. Age alone does not determine suitability: the lower eyelid, cheek support, skin and expectations are considered together.
Advanced skin laxity, prominent bags, festoons or persistent swelling may require surgery or another approach. Trying to correct every under-eye concern with filler is not appropriate.
Treatment is postponed if there is an active infection, an open wound or inflammation in the area. Severe allergy to a product ingredient, a previous serious filler reaction and bleeding disorders require separate assessment. Immune system conditions, medication and previous procedures may affect the decision to treat.
Elective aesthetic treatment is postponed during pregnancy and breastfeeding. Any permanent filler or filler of unknown composition already present in the area must be clarified before further injections.
What do I assess before treatment?
I assess both tear troughs together with skin thinness, bags, eyelid laxity, swelling, cheek support and facial asymmetry. I compare these findings with the changes the patient expects from filler.
Please report the product, date and amount of any previous filler, as well as eyelid surgery, fat injections, allergies, eye conditions and medication. In selected cases, an examination such as ultrasound may be requested to assess existing filler or swelling.
Do not stop prescribed medication, including blood thinners, on your own. Even when the aim is to reduce bruising, any medication change must be agreed with the prescribing doctor. Recent infections and planned dental procedures should also be discussed.
Hyaluronic acid, CE conformity and UTS registration
Hyaluronic acid binds water. A filler's structure, water-binding behaviour and intended treatment area matter; a product used elsewhere on the face may not be suitable beneath the eyes.
The product's CE conformity information, registration in Türkiye's Product Tracking System (UTS), intended use, packaging integrity, batch number and expiry date should be checked. You can ask for the name of the product, the amount used and information about its instructions for use.
Documentation and registration do not mean that treatment is suitable for everyone or that complications cannot occur. Product selection, its instructions for use and individual assessment all matter.
How is under-eye filler performed, and how long does it take?
After assessment and planning, the skin is cleaned and controlled amounts of the selected product are placed in the appropriate tissue plane. I perform under-eye filler only with a cannula. I choose this approach to reduce the risk of vascular injury and occlusion; using a cannula does not eliminate that risk.
In my practice, the procedure takes approximately 10–15 minutes. Consultation, preparation and observation afterwards are separate from this time. Stinging, pressure, pulling or tenderness may be felt; a completely pain-free procedure cannot be promised.
If the product contains a local anaesthetic, any relevant allergy history is also assessed.
How much under-eye filler is used, and is one session enough?
For the first treatment, I usually use a total of 1 ml of hyaluronic acid filler for both under-eye areas. I determine its distribution between the two sides according to hollowing, existing asymmetry, previous filler and tissue characteristics.
In my own practice, few patients return requesting additional filler after their first treatment. Individual needs vary. If additional filler is needed, I prefer an interval of two weeks; I reassess swelling and the condition of the tissues before treatment.
The under-eye area is sensitive to small differences in volume. Excess filler may cause puffiness and uneven contours. Swelling should not be mistaken for a hollow or insufficient filler and treated with more product before assessment.
How long does under-eye filler last?
The visible effect of hyaluronic acid under-eye filler may last around a year in many people. It can be shorter or longer depending on the product, amount, tissues and previous treatment; the same duration cannot be guaranteed for everyone.
A reduction in the visible effect does not mean that all filler has disappeared. Product may remain in the tissues for longer. Repeat treatment should not be scheduled automatically: remaining filler and any swelling need to be assessed.
Swelling, bruising and aftercare following under-eye filler
Swelling, bruising and a temporary difference between the two sides may occur during the first few days. Bruising can sometimes be noticeable and last around two weeks. Assessment becomes more meaningful as swelling settles; the first day's appearance is not the complete result.
Do not rub, press or massage the area unless your doctor advises it. Do not apply makeup to injection sites on the day of treatment. Avoiding strenuous exercise, excessive heat and significant pressure during the first 24–48 hours is advised; follow your individual aftercare plan.
If all is well, you can return to everyday activities and light work immediately after treatment. Restrictions on strenuous exercise and pressure to the area still apply. Swelling or bruising may affect appearance. Persistent or recurrent swelling, increasing pain, redness or colour changes require assessment.
Can under-eye filler be dissolved?
For the hyaluronic acid fillers I use, reduction or dissolution with hyaluronidase may be considered when there is an appropriate reason. More than one treatment may be needed.
I never use permanent fillers and do not endorse their use. If permanent filler or filler of unknown composition has previously been used in this area at another clinic, it requires separate assessment before further treatment.
Dissolving filler can itself cause allergy, swelling, bruising and unwanted volume changes. A complete return to the previous appearance or full resolution of a complication cannot be guaranteed. In particular, dissolving filler does not guarantee recovery from filler-related vision loss.
What alternatives may be considered?
Choosing no treatment is also an option. Depending on the cause of the concern, treatments directed at skin or pigmentation, or lower eyelid surgery, may be considered.
For significant bags and excess skin, lower eyelid surgery may be more appropriate. Each option's extent, recovery and risks require separate assessment.
I never choose fat injection for the under-eye area. I do not recommend fat filler as part of my treatment approach for this region.
Risks and unwanted outcomes of under-eye filler
Every medical intervention, procedure and operation carries risks. Depending on the nature of the treatment and the individual's health, death, disability, and temporary or permanent unwanted functional and/or aesthetic outcomes may occur.
No medical intervention, procedure or operation guarantees that the patient will obtain the desired result or results.
Risks differ in frequency and severity. Alongside prolonged swelling and appearance-related problems specific to the under-eye area, rare but serious vascular complications, tissue loss, permanent blindness and stroke have been reported. The headings below explain these risk groups in detail.
Early effects: pain, bruising and altered sensation
- Injection-related effects. Pain, burning, itching, redness and tenderness may occur.
- Bleeding and haematoma. Bruising or a collection of blood may be more pronounced than expected, last longer and require further assessment.
- Altered sensation and fainting. Numbness, unusual sensations, dizziness or fainting may occur. Persistent symptoms should be reported.
Prolonged swelling, puffiness and lymphatic problems
- Persistent or recurrent swelling. The under-eye area is prone to fluid retention. Swelling may last for weeks or months and can also appear later.
- More prominent existing bags. Filler volume or fluid retention may increase bulging in the lower eyelid and upper cheek.
- Further treatment. Monitoring, medication, dissolving filler or other interventions may be needed. Complete spontaneous resolution of swelling cannot be guaranteed.
Colour, contour and symmetry problems
- Tyndall effect. Filler placed too superficially may produce a blue-grey appearance beneath the skin.
- Irregularities and lumps. Product may be visible or palpable, with bumps, depressions or uneven contours.
- Overcorrection or undercorrection. The under-eye area may look puffy, hollowing may persist or new asymmetry may develop.
- Migration and colour changes. Filler may become noticeable outside the intended area. Bruising-related colour changes can sometimes persist and require further treatment.
Infection and delayed inflammatory reactions
- Infection. Warmth, redness, painful swelling, an abscess or a draining wound may develop. Medication, drainage or surgery may be needed.
- Delayed nodules and granulomas. Inflammatory lumps and recurrent swelling may appear weeks, months or later after treatment.
- Triggered reactions. Some delayed reactions may become apparent after infections or dental procedures. The cause is investigated through assessment.
- Wounds and scars. Infection or tissue damage may cause permanent scarring and deformity.
Vascular occlusion, tissue loss, blindness and stroke
- Impaired circulation. Filler entering a blood vessel or compressing one may compromise the blood supply to the tissues.
- Tissue death. Necrosis, open wounds, infection, permanent scars or loss of contour may occur.
- Vision loss. Visual disturbance and permanent blindness have been reported after facial filler injections, including under-eye treatment. Vision loss may be accompanied by eyelid drooping or impaired eye movements.
- Stroke and permanent harm. Very rare vascular events may cause stroke, paralysis and permanent disability. Emergency treatment may not reverse all damage.
Allergy and life-threatening reactions
- Allergy to the product or other substances. A reaction may occur to the filler, an anaesthetic it contains or other substances used during treatment.
- Anaphylaxis. A severe allergic reaction affecting breathing or circulation requires emergency care and hospital treatment and may result in death.
- Risks of dissolving filler. Hyaluronidase carries its own risks, including serious allergy. Any additional treatment needed is explained separately.
Results, further procedures and long-term uncertainties
- Unwanted aesthetic or functional outcomes. Dark circles, hollows or a tired appearance may not improve as much as expected. Temporary or permanent unwanted outcomes may occur.
- Further intervention. Medication, imaging, dissolving filler, hospital treatment or surgery may be needed; these have their own risks and costs.
- No guarantee. Neither a single nor repeated treatment guarantees perfect symmetry, a specific duration, the desired appearance or complete resolution of a complication.
Which symptoms require urgent attention?
If you develop unusual or increasing pain, skin blanching, a mottled purple colour or coolness, contact the treating doctor immediately. Do not wait on the assumption that these are ordinary bruising or swelling.
For sudden blurred vision, vision loss or double vision; difficulty speaking or weakness in the face or limbs; breathlessness, tongue or throat swelling, or fainting, call 112 or attend an emergency department. Tell the team that you have had filler injections and do not drive yourself.
This information does not replace an individual examination and the informed consent discussion before treatment. Individual or unexpected risks not listed here may also occur. Reading this page does not constitute consent to treatment.
Frequently asked questions about under-eye filler
Does under-eye filler completely remove dark circles?
No. It may reduce shadows caused by hollowing, while darkness related to pigmentation, thin skin or visible vessels may persist. The cause of the dark circles needs to be assessed.
What causes under-eye hollows?
Inherited facial and bone structure, volume distribution and age-related tissue changes may contribute. Lack of sleep alone does not explain every hollow.
Can filler treat under-eye bags?
A limited groove and mild bags may be assessed together. With prominent bags, excess skin or swelling, filler may be unsuitable and may increase puffiness.
How many months does tear trough filler last?
The visible effect may last around a year in many people. It can last for a shorter or longer period; this is not an individual guarantee.
When does under-eye filler settle?
It is assessed more accurately once swelling and bruising have reduced. Additional filler should not be decided on during the first few days; prolonged swelling requires review.
How long does swelling after under-eye filler last?
Mild swelling may reduce during the first few days, but in some people it lasts longer or recurs. Increasing, painful, red or persistent swelling needs assessment.
Is 1 ml of filler enough for both under-eye areas?
For the first treatment, I usually use 1 ml in total for both under-eye areas. Its distribution and any additional requirement depend on the hollows and tissue characteristics.
Is one session of under-eye filler enough?
In my own practice, few patients return requesting additional filler after their first treatment. If further filler is needed, I prefer an interval of two weeks; the decision follows assessment of the area.
Do you use a cannula or a needle for under-eye filler?
I perform under-eye filler only with a cannula, with the aim of reducing risk. A cannula does not eliminate the risk of serious complications, including vascular occlusion.
Does under-eye filler hurt?
Stinging, burning, pulling or pressure may be felt. Pain control and product ingredients are assessed individually; a pain-free procedure cannot be guaranteed.
Can I return to work after under-eye filler?
If all is well, you can return to everyday activities and light work immediately after treatment. Follow the aftercare advice about strenuous exercise and pressure to the area.
Can I wear makeup after under-eye filler?
Do not apply makeup to injection sites on the day of treatment. Avoid rubbing the skin or applying significant pressure during subsequent care and follow the advice you receive.
Can I exercise or use a hammam or sauna after under-eye filler?
Strenuous exercise and excessive heat are not advised during the first 24–48 hours. The timing of a hammam, sauna and other activities depends on swelling and your individual aftercare plan.
Can I have filler if my under-eyes are puffy in the morning?
The cause of the swelling should be investigated. A tendency to retain fluid matters because swelling may increase or persist after under-eye filler.
Can under-eye filler look blue or grey?
Yes. A colour change called the Tyndall effect may develop. Not every bruise is a Tyndall effect; the cause is distinguished through assessment.
Should I massage lumps after under-eye filler?
Do not massage the area yourself. Lumps may relate to product placement, swelling or inflammation; the appropriate approach is determined after assessment.
Can under-eye filler cause blindness?
Although rare, permanent blindness has been reported after facial filler injections. A sudden change in vision is an emergency; do not wait for a scheduled review or assessment from photographs.
Can under-eye filler be dissolved?
Hyaluronic acid filler can be reduced with hyaluronidase when appropriate. More than one procedure may be needed; not every material can be dissolved, and dissolution has its own risks, including allergy.
Will my under-eyes definitely return to their previous appearance when filler wears off?
This cannot be promised. Previous procedures, ageing and tissue changes affect appearance; an exact return to the starting appearance cannot be guaranteed.
Should under-eye filler be repeated every year?
No. It should not be repeated according to a calendar without assessing remaining filler, swelling, previous reactions and current need.
Can I have further treatment if I have already had under-eye filler?
The previous product and its current condition need to be understood. In particular, new filler should not simply be added over permanent, unknown or problematic filler.
Can filler be used after lower eyelid surgery?
Healing, eyelid support, the extent of previous surgery and any remaining hollowing are assessed together. A history of surgery alone does not determine suitability.
Are under-eye filler and fat injection the same?
No. Hyaluronic acid is a manufactured filler material, while fat injection uses a person's own fat. I never choose fat injection for the under-eye area and do not recommend fat filler for this region.
Is under-eye filler the same as botulinum toxin or skin boosters?
No. Filler aims to support volume and contour, whereas botulinum toxin reduces selected muscle movements. Treatments described as skin boosters also need separate assessment of their ingredients and purpose.
Can men have under-eye filler?
Suitability is assessed through anatomy, health and expectations regardless of gender. Perfect equality between the two sides or a particular facial appearance cannot be guaranteed.
At what age can someone have under-eye filler?
Elective aesthetic treatment is assessed in adults. Turning 18 is not sufficient on its own: the product's age restrictions and the individual's needs must also be considered.
Can under-eye filler be used during pregnancy or breastfeeding?
Elective aesthetic treatment is postponed during these periods. Safety uncertainties should be explained during the individual consultation.
Can eye cream or concealer replace filler?
Concealer may temporarily cover a colour difference, but creams and skincare do not fill a volume deficit. However, not every dark circle requires filler.
What should I do if my vision becomes blurred after under-eye filler?
If sudden blurring, reduced vision or double vision occurs, call 112 or attend an emergency department and tell the team that you have had filler injections. Do not drive yourself.
Why does the cost of under-eye filler vary?
The product, amount, extent of treatment, assessment of previous filler and any further interventions needed affect cost. An individual plan is determined after consultation.
Do you use permanent under-eye fillers?
No. I never use permanent fillers and do not endorse their use. Any previous permanent filler or filler of unknown composition requires separate assessment.
What affects the cost of under-eye filler in Antalya?
When researching under-eye filler costs in 2026, consider the product, volume required, extent of treatment, existing filler and follow-up plan together. Any need for dissolving filler, imaging or other treatment is discussed separately.
When researching under-eye filler in Antalya, comparing only millilitres or price is insufficient. First, the under-eye concern needs to be assessed for suitability for filler. The individual plan and its scope are then explained.
Sources
This original patient information page was prepared using the general risk framework in the ASPS hyaluronic acid filler consent document, information specific to the under-eye area and scientific publications. The treatment technique, duration, volume, interval for additional treatment and return to everyday activities reflect Dr Onur Serin's own clinical practice. Sources reviewed and page updated: 27 October 2026.
- American Society of Plastic Surgeons — Informed Consent: Hyaluronic Acid Filler Injection (2020); general filler consent document.
- ACE Group — Tear Trough Dermal Fillers: patient information specific to the under-eye area. ↗
- Anido et al. — Recommendations for the treatment of tear trough deformity with cross-linked hyaluronic acid filler. J Cosmet Dermatol. 2021;20:6–17. ↗
- Infraorbital Hollow Rejuvenation: Considerations, Complications, and the Contributions of Midface Volumization. ↗
- American Society of Plastic Surgeons — Dermal Fillers: Risks and Safety. ↗
- American Academy of Dermatology — Fillers: Preparation. ↗
- FDA — Dermal Fillers (Soft Tissue Fillers): general safety and complication information. ↗
- Turkish Medicines and Medical Devices Agency (TITCK) — Product Tracking System (UTS). ↗
- Republic of Türkiye Ministry of Trade — CE conformity assessment for medical devices. ↗