If you’re wondering how to get rid of dark circles, under eye bags, shadowing, or hollow tear troughs, you’re not alone. These are common concerns that bring people of all ages to Mabrie Facial Institute in San Francisco. But isolated under eye tear trough filler injections are rarely the best solution for dark circles and eye bags. The key to complete, natural-looking results is to address the cheekbones, midface, and tear troughs as one aesthetic unit. At MFI, we discover the cause of your bags and circles and design your filler treatment to give you a refreshed, bright-eyed look that lasts.

How To Treat Dark Circles and Under Eye Bags: Your Treatment Options at MFI

Understanding what’s going on beneath your eyes is key to understanding how to treat your dark circles and under eye bags. At MFI, we get consistently better results with under eye fillers by addressing the problem at its source. 

Complete Under Eye Rejuvenation

For about 90% of our patients seeking under eye rejuvenation, our approach to correcting under eye bags and dark circles involves starting with the cheeks and midface, which provide support to the under eye area. This method produces superior, lasting results when compared to simply injecting dermal fillers under the eyes.

Add Support and Structure

Often, volume loss in the cheeks and midface is the main culprit of dark circles and under eye bags. When we lose volume in these areas, we leave the tear trough unsupported and sunken. Adding volume to the cheek and midface using fillers like JUVÉDERM® VOLUMA® and RADIESSE® creates support for under eye fillers. With that structure in place, we can smooth tear troughs using less filler and eliminate the risk of filler migration or pooling.

Smooth Away Shadows

We layer Restylane® to the tear trough area to create an even, shadow-free surface that reflects light. We carefully fill in hollows and smooth bags, creating a seamless transition between the under eye area, the cheekbone, and the midface.

In our many years of dedicated experience and treating thousands of patients, we’ve learned that treating a single area on its own is usually ineffective and could make the area look worse. Without addressing the midface, you can get a drooping/puddle effect that creates heavier under eye bags and nasolabial folds—the exact opposite of what you want. When we add structural support in the midface, it allows the filler to remain precisely where we want it.

Highlighted treatment area on a model's face for Complete Under Eye Rejuvenation.
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Before
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After

This is a perfect illustration of how important the cheeks are in framing and treating the eye area. Midface and cheek filler gave her eyes the noticeable support that she was lacking. We applied Restylane Lyft and Restylane to her tear troughs, cheeks, and nasolabial folds. The shadows under her eyes and around her nose have disappeared.

Patient before baggy under eye treatment
Before
Patient after baggy under eye treatment
After

This former athlete in his 40s struggled with how to fix his under eye bags for many years. After unsuccessfully trying out every eye cream out there to refresh his appearance, he decided to give fillers a chance. Our Midface Rejuvenation package addressed his under eye bags and dark circles. Volume was added to his midface using JUVÉDERM VOLUMA. Restylane was then added to camouflage the junction of the under eye and cheek, creating a smooth transition.

Patient before fillers creating a smooth and lifted midface and under-eye bags
Before
Patient after fillers creating a smooth and lifted midface and under-eye bags
After

Our Injector used various densities of filler to create a smooth and lifted midface and camouflage the under eye bags and dark circles. To complement his refreshed look, UPNEEQ (a prescription eye drop) opens up the eyes for that extra sparkle!

Image
Before
Image
After

This is a perfect illustration of how important the cheeks are in framing and treating the eye area. Midface and cheek filler gave her eyes the noticeable support that she was lacking. We applied Restylane Lyft and Restylane to her tear troughs, cheeks, and nasolabial folds. The shadows under her eyes and around her nose have disappeared.

Patient before baggy under eye treatment
Before
Patient after baggy under eye treatment
After

This former athlete in his 40s struggled with how to fix his under eye bags for many years. After unsuccessfully trying out every eye cream out there to refresh his appearance, he decided to give fillers a chance. Our Midface Rejuvenation package addressed his under eye bags and dark circles. Volume was added to his midface using JUVÉDERM VOLUMA. Restylane was then added to camouflage the junction of the under eye and cheek, creating a smooth transition.

Patient before fillers creating a smooth and lifted midface and under-eye bags
Before
Patient after fillers creating a smooth and lifted midface and under-eye bags
After

Our Injector used various densities of filler to create a smooth and lifted midface and camouflage the under eye bags and dark circles. To complement his refreshed look, UPNEEQ (a prescription eye drop) opens up the eyes for that extra sparkle!

Partial Under Eye Procedure

While most people need support in the midface to get the best results for their under eyes, approximately 10% of our patients can get by with a scaled-down treatment. For these individuals, we offer a more limited under eye procedure.

This approach may be ideal for patients who:

  • Have minimal volume loss in the midface and tear trough
  • Have existing filler to the area from an outside injector
  • Do not wish to address their cheeks

If you have minimal circles and/or bags, we offer this scaled-down, 1-appointment procedure which uses less filler and comes at a lower cost

Highlighted treatment area on a model's face for Under Eye Rejuvenation.

How Much Does Under Eye Tear Trough Filler Cost?

The cost for full under eye rejuvenation includes your first appointment and up to 4 syringes of filler, as well as your second appointment. If additional syringes are needed, those are priced at a reduced rate.

Partial or mini under eye treatment includes 2 syringes of filler. All prices are based on the Injector. Please visit our dedicated pricing page for the most up-to-date information.

Once you’re happy with your under eyes, you move into the maintenance phase of treatment. From this point on, we only need to see you once every 9 to 12 months. During these appointments, we touch up the midface and under the eyes, typically only using 1 to 2 syringes.

Qualified borrowers may be eligible for 0% financing for 6 to 12 months through CareCredit and Alphaeon medical financing.

The MFI Advantage

MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.

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What Causes Dark Circles And Under Eye Bags?

Understanding what’s going on beneath your eyes is key to understanding how to treat your dark circles and under eye bags. At MFI, we get consistently better results with under eye fillers by addressing the problem at its source.

Volume Loss in the Midface

Fat and bone create the structure in the middle of your face—between your nose and your cheekbone—that supports the under eye area. As these break down over time, the lack of support causes the area beneath the eyes to sink and droop. The result is hollowing of the tear trough area and sometimes “bags” of displaced fat, both of which cast shadows. This is the main reason for most of our clients’ dark circles and bags.

Volume Loss in the Midface

Patient front facing before under eye bag treatment
Before
Patient front facing after under eye bag treatment
After
Patient side facing before under eye bag treatment
Before
Patient side facing after under eye bag treatment
After

Your Genes

Some people are genetically predisposed to hollows or bags under their eyes and may have them at a very young age.

Other Causes

It’s important to understand that some people have dark circles that aren’t caused by shadows or contour irregularities. These include hyperpigmentation—or excess melanin around the eyes—and visible blood vessels.

In cases of hyperpigmentation, tear trough fillers may not be able to completely correct the darkness, but they can improve shadows if there is volume loss in the area in addition to pigment. By replacing the shadow with a smooth, flat surface, the skin reflects light, brightening the under eye area. While this doesn’t erase hyperpigmentation, it can significantly improve the appearance of this area.

Your Injector will help you determine whether your dark circles can be corrected with filler.

Consultation and Planning for Your Under Eye Rejuvenation

Your First Visit

Your successful tear trough filler experience starts with a thorough consultation with one of our Injectors at our chic, friendly San Francisco office. First, we have an in-depth conversation to get clear on your aesthetic goals and expectations. Next, we take professional-level photographs of your under eyes from all angles. We utilize these photos at every visit to identify your concerns and monitor your progress. Using both the photos and the in-person examination, we map out a customized treatment plan tailored to your anatomy and goals. 

Please plan to spend about 3 hours in the office for your first visit, which includes consultation, prep, treatment, pre- and post-treatment photography, aftercare education, and scheduling your next appointment.

Your Under Eye Filler Procedure Takes Two Treatments

Your under eye filler procedure requires a minimum of 2 appointments. This staged approach allows us to create structure, support, and superior, natural-looking results. Too much filler all at once can create obvious results, and it’s better to build and layer until we get it just right. 

For more information about your treatment, visit Your Treatment Timeline. 

Example of 2 Treatment Process

Before under eye treatment
Before
after 2 of 3 under eye treatment
After 2 of 3 Treatments
after 3 of 3 under eye treatment
After 3 of 3 Treatments

Preparing for Your Procedure

For the best filler experience, follow these tips in advance of your appointment:

  • A few days before your appointment, restrict blood thinners such as anti-inflammatories, fish oil, and alcohol. Limiting these will reduce your risk of bruising from under eye filler.
  • DO NOT discontinue prescribed, medically necessary, medications.
  • Eat and drink a normal breakfast or lunch prior to your appointment; low blood sugar can make patients lightheaded during treatment.

Recovery & Aftercare

Immediately after tear trough filler, you may experience swelling, bruising, tenderness, and redness. These are normal side effects and are most apparent 24 to 48 hours after treatment. They can last several weeks, but typically subside within 2 to 5 days. Most patients return to their routine activities the same day.

Swelling

  • Initial swelling may appear full or puffy with maximum swelling the day after treatment
  • This may cause temporary asymmetry, lumps, or bumps
  • Will gradually resolve to reveal your final results over 4 to 6 weeks

Bruising

  • While bruising is possible, it is usually minimal 
  • It is less common (<5%) to have more severe under eye bruising

Redness & Discomfort

  • Often minimal and lasting just a few days

Downtime

  • No downtime required
  • May return to work immediately after treatment
  • May resume normal exercise the next day

Because we know you have questions about your recovery process, we created an entire page dedicated to BOTOX and dermal filler aftercare.

Example of Recovery After Under Eye Filler

1 Day After Under Eye Treatment
3 Days After Under Eye Treatment
3 Weeks After Under Eye Treatment

Aftercare Pro Tips

Be sure to check out our After Treatment video for helpful tips during your recovery.

Under Eye Filler FAQs

How long does under eye tear trough filler last?

Depending on which fillers are used and which areas are treated, your results can last from 6 to 18 months or longer. Dermal fillers are temporary products that require touch-ups to maintain results.   We recommend maintenance appointments at 9- to 12-month intervals to keep your results looking fresh. For more in-depth information about the longevity of fillers, visit our page on How to Make Your Results Last.


What is the best filler for under the eyes?

Generally, for under eye rejuvenation, we use Restylane® as our go-to tear trough filler, and JUVÉDERM® VOLUMA® is our favorite of the cheek fillers. Both are hyaluronic acid fillers, which means they are reversible, and there is virtually no risk of allergic reaction. Learn all about the fillers we use by visiting Dermal Fillers 101


Does under eye filler hurt?

A lot of patients ask Is tear trough filler painful? We have numerous techniques to help alleviate discomfort. We use a combination of topical lidocaine and injectable lidocaine to numb the area. For those who may be a little extra anxious we also offer nitrous oxide (aka laughing gas), to help calm some of your nerves. As a bonus, all our fillers have lidocaine in them, so the treatment area continues to become increasingly numb as the filler treatment continues.


What if I have very minimal dark circles?

Sometimes a person can benefit from a single-area treatment, but rarely. For certain individuals, we offer a limited under eye procedure. If you have minimal circles and/or bags, we offer this scaled-down procedure which uses less filler and comes at a lower price point.

The MFI Advantage

MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.

Schedule Me

We’d Love To See You

If you are interested in learning more about under eye fillers for dark circles and bags, request a consultation online and ask for Under Eye Filler/Midface Rejuvenation. Or you can call us at (415) 445-9513 to schedule your first two appointments with one of our highly trained specialists. If you’ll be visiting us from outside the area, our Fly in for Your Procedure page was created just for you to help make planning your trip as smooth as possible.

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