Under-eye filler
Tear trough filler · 'eye bag' filler · periorbital rejuvenation
One of the most-searched filler treatments and, by a distance, the most-regretted.
Search interest: about 400 searches a month in Singapore for “under eye filler” (Ahrefs, October 2026).
Puffiness after filler is not one problem but four, and ultrasound tells them apart — before anyone injects, the question is hollow or bag.
Reviewed against the Aesthetics International standard. Category: Injectables.
Does Under-eye filler work?
Caution. Puffiness after filler is not one problem but four, and ultrasound tells them apart — before anyone injects, the question is hollow or bag. Good results in well-selected hollows with conservative volumes of appropriate low-water-binding filler.
- Verdict
- Caution Evidence, regulation or risk profile does not yet support routine use.
- Evidence base
- 3 PubMed-indexed studies cited below, including systematic reviews.
- Suits
- A true tear trough hollow with good skin thickness and no fat herniation, in conservative hands.
- Not for
- Eye bags, puffiness, very thin or crepey skin, anyone with previous under-eye swelling after filler.
- In Singapore
- HA fillers are registered devices injected by doctors.
- Category
- Injectables · about 400 searches a month in Singapore for “under eye filler”
- Reviewed
- 1 October 2026 by Aesthetics International. Revised as evidence and regulation change.
What it is
Hyaluronic acid filler placed in the tear trough to soften the shadow between the lower lid and cheek. It works for a hollow; it does not work for a bag, and most people searching for it have a bag.
How it works
A hollow is a lack of volume; a bag is herniated fat sitting above a hollow; puffiness is fluid. Filler helps only the first. Placed under a bag it adds weight and swelling; placed too superficially in thin skin it causes a bluish Tyndall tint; too much produces the puffy, lumpy under-eye that is now routinely dissolved.
What the evidence says
Good results in well-selected hollows with conservative volumes of appropriate low-water-binding filler. Complications cluster in poorly selected candidates and over-filled eyes. Dissolving is possible — hyaluronidase dissolves hyaluronic acid — but dissolving filler is not an undo button; swelling and skin changes can persist.
What people are saying
Paraphrased from public discussion on TikTok, Instagram, Reddit and in the press. Not testimonials, and not about any one clinic. Reported in: health.clevelandclinic.org, realself.com.
What the studies show
- systematic review
Pooled studies in selected patients reported high satisfaction and a low rate of complications, mostly swelling, bruising and contour irregularity; the studies were short-term and in experienced hands.
The Efficacy and Safety of Hyaluronic Acid Injection in Tear Trough Deformity: A Systematic Review and Meta-analysis. — Aesthetic Plast Surg, 2024. PMID 37684413.
- systematic review
Delayed complications included persistent oedema, malar mounds, Tyndall discolouration and nodules, sometimes appearing months to years after injection.
Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review. — Facial Plast Surg, 2022. PMID 34666405.
- systematic review
Prospective trials reported mostly mild adverse events, with the authors noting that vascular complications, though rare, are the serious risk of this region.
Safety of infraorbital hyaluronic acid injections: Outcomes of a meta-analysis on prospective clinical trials. — J Cosmet Dermatol, 2023. PMID 37424173.
Studies are selected for relevance and quality, not for agreement with the verdict; PubMed records are linked so the reader can check them.
Who it suits
Suits
A true tear trough hollow with good skin thickness and no fat herniation, in conservative hands.
Not for
Eye bags, puffiness, very thin or crepey skin, anyone with previous under-eye swelling after filler.
Alternatives
The two reviewed treatments most often weighed against Under-eye filler, on the same standard.
| Under-eye filler | PDRN and polynucleotides | Skin boosters | |
|---|---|---|---|
| Verdict | Caution | Established | Established |
| What it is | Hyaluronic acid filler placed in the tear trough to soften the shadow between the lower lid and cheek. | Polynucleotides are DNA fragments, usually purified from salmon or trout gonads, injected into the dermis in micro-droplets. | Micro-injections of hyaluronic acid, sometimes with vitamins, amino acids and antioxidants, placed superficially across the face to hydrate and improve texture and glow. |
| Evidence base | 3 PubMed-indexed studies cited below, including systematic reviews. | 3 PubMed-indexed studies cited below, including systematic reviews, randomised trials. | 3 PubMed-indexed studies cited below, including randomised trials. |
| Suits | A true tear trough hollow with good skin thickness and no fat herniation, in conservative hands. | Thin, crepey under-eye skin; dull, inflamed or acne-prone skin; post-procedure recovery; people who want quality rather than volume. | Dull, dehydrated skin; make-up that settles into fine lines; neck and décolletage. |
| In one line | Puffiness after filler is not one problem but four, and ultrasound tells them apart — before anyone injects, the question is hollow or bag. | The injected courses are a sensible part of a skin plan; the salmon-sperm facial is mostly the microneedling doing the work. | Dull skin is a collagen problem — boosters hydrate the surface while collagen work happens underneath. |
Risks
Puffiness that worsens over years, Tyndall effect, lumps, and rarely vascular occlusion with visual loss — the under-eye is a high-risk zone.
In Singapore
HA fillers are registered devices injected by doctors. Correction of over-filled under-eyes is a regular part of Dr Sin Yong's practice.
“Puffiness after filler is not one problem but four, and ultrasound tells them apart — before anyone injects, the question is hollow or bag.”
Vetted protocols on the same problem
Questions
Will filler fix my eye bags?
What are the alternatives?
Can under-eye filler be dissolved?
Cite this review
Aesthetics International (2026). Under-eye filler: does it work? Evidence, risks and verdict. https://aesthetics-international.org/treatments/under-eye-filler/ (reviewed 1 October 2026).
Editorial, unpaid and independent of any manufacturer. Verdict: Caution. See what works and what doesn't across all 153 reviews. Spotted an error or a newer study? Suggest a correction — changes are logged on the corrections page. Terms are defined in the glossary.
Where this review is used
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