Dermal Fillers

The tear trough is the groove that runs from the inner corner of the eye down along the nose. As volume beneath the lower eyelid decreases with age, this groove deepens, creating shadows that can make you look tired. Carefully placed filler in the tear trough can soften this shadow and reduce the appearance of dark circles. Because the under-eye skin is exceptionally thin, this area requires precise technique and thorough knowledge of periocular anatomy, which is why treatment by an oculoplastic surgeon offers an added measure of safety. You can learn more about this specific approach on our facial filler around the eyes page.

Temporal hollowing occurs when the fat pads above and around the temples shrink, giving the upper face a gaunt or angular look. Filler placed in the temples can restore a youthful convexity to this area and indirectly lift the tail of the eyebrow. For patients with more significant brow drooping, our team may discuss whether a surgical brow lift would better achieve their goals.

Volume loss in the cheeks contributes to a flattened midface and can accentuate under-eye hollows by reducing the structural support below the lower eyelid. Restoring cheek volume with fillers creates a lifting effect that can improve the entire periocular area. This approach is sometimes combined with direct under-eye treatment for a more balanced result.

Both Juvederm and Restylane are HA-based filler families, but they differ in their manufacturing processes and gel consistency. Juvederm products use Vycross or Hylacross technology, which tends to create a smoother gel, while Restylane uses NASHA or XpresHAn technology, producing a slightly firmer, more cohesive product. In practice, both families offer excellent options, and the choice often comes down to which specific product best matches the treatment area.

When performed by a qualified provider with thorough knowledge of periocular anatomy, filler injections near the eyes have a strong safety profile. The eye area contains a complex network of blood vessels, making proper injection technique critical to avoid complications such as vascular occlusion (blockage of a blood vessel). This is one reason we recommend having periocular fillers administered by an oculoplastic surgeon who specializes in the structures surrounding the eye.

The most common side effects include temporary bruising, swelling, redness, and tenderness at the injection site, which typically resolve within a few days. Less common but more serious risks include infection, filler migration, nodule formation, and vascular occlusion. Choosing an experienced provider, following pre-treatment and post-treatment guidelines, and selecting an appropriate filler product all help minimize these risks.

Botox temporarily relaxes muscles to reduce dynamic wrinkles that form with facial expressions, such as crow's feet and forehead lines. Fillers restore volume and smooth wrinkles that are visible even when the face is at rest. Many patients benefit from combining both treatments for a more complete rejuvenation of the eye and brow area.

HA fillers can be partially or fully dissolved using an injection of hyaluronidase, an enzyme that breaks down hyaluronic acid. This provides an important safety net, allowing adjustments if you are unhappy with the result or if a rare complication arises. The dissolving process usually takes effect within 24 to 48 hours. Non-HA fillers such as Radiesse and Sculptra cannot be enzymatically dissolved, which is one reason HA fillers are often preferred for first-time patients and sensitive areas like the tear trough.