How long do under eye fillers last?

You’re here because you are wondering how long does under eye filler last.

There’s a short answer and a long answer to the question “how long do fillers last under the eyes”.

The short answer:

it depends but anywhere from 6 months to several years with a single treatment.

Yes, that’s a big range. So, read on for the longer, more detailed answer.

After Restylane to the tear trough for bag and dark circle reduction

First: The rising popularity under-eye filler treatment

When I started performing under-eye fillers in 2008 it was relatively unheard of. I had completed a fellowship in oculoplastic surgery involving both surgery and nonsurgical procedures around the eyes and face and the idea of using temporary, biocompatible volume made sense for many areas on the face, especially under the eyes where we tend to develop bags and dark hollows as we age.

In 2011, I started to incorporate the use of cannulas for under eye fillers, the same type of tubes that had been used for fat injections for years. By 2012, I was almost exclusively using cannulas as the single-use, disposable varieties became available. This made the procedure almost pain-free and bruise-free and arguably made the procedure safer.

In the last 3 years, particularly in New York City, Los Angeles and other major U.S. cosmetic surgery hubs, the procedure gained widespread popularity as many nurse injectors, physician assistants, and other physician extenders adopted the use of the cannulas, likely due to the safety factor of cannulas (they are less likely than needles to cause injections of filler gel into blood vessels) and due to the wide array of online and in-person injection training courses now available.

More numbers of injectors placing filler under the eyes means there is a wide array of techniques, types of fillers being used, and amounts of fillers being placed. These variables influence how long the fillers will last.

Factors that determine how long under eye fillers will last:

1. The type of under eye filler
There are permanent fillers that will last indefinitely. Fillers like silicone, acrylic, and calcium. I don’t recommend any of these for under the eyes. The vast majority of under eye fillers being used today are made from a string of sugar molecules called hyaluronic acid. Fillers like Restylane, Juvederm, Belotero, Kysse, Lyft, Silk, Refyne, Volbella, Vollure, Versa, and the list keeps growing. These have different concentrations of hyaluronic acid, differently sized particles, and different amounts of cross-linking holding the chains of molecules together. These qualities change how long they will last. For example, Belotero is very thin and runny and may only last 6 months while Restylane is somewhat firmer and is more cross-linked and may last 12 or 16 months.
2. The way the under eye filler is placed
The truth is that all hyaluronic fillers stay in the body for longer than a year, sometimes they last for 5 years (I’ve seen it). Over time the fillers gradually degrade from as our body creates and enzyme called hyaluronidase that cleaves the bonds of the sugar chains in the gel. As the amount of filler volume lessens, the effect wanes. But filler placed close to the surface of the skin will be more noticeable for a longer period. This isn’t necessarily a good thing. Shallow filler can look bluish or lumpy. Deeper filler may appear to disappear faster, but it’s just covered by more of your tissue, like a thicker blanket. Deep filler tends to look more natural but you may find that when 50% of the filler has been absorbed by your body you’ll feel that 100% is gone. The point is that technique matters in how your filler looks and how long it looks good.
3. How much filler is placed under the eyes (and the surrounding areas)
A little bit of filler can go a long way in reducing or eliminating under-eye shadows but can also seem to dissipate in less than a year. A lot of filler can be helpful when someone has dramatic cheek deflation from aging or very deep under-eye grooves. And a lot of filler may seem to last for more than a year. In some situations, a lot of filler doesn’t look great under the eyes. It can distort the natural contours and slopes. If that happens to you, it’s best for the filler to not last for years and you may in fact need to have the filler reversed with an enzyme injection called hyaluronidase.

Here’s what I want to share about under eye filler after doing thousands of these treatments:

The average time range when people return because they feel their under-eye fillers have dissipated is 9-12 months.
If the filler seems to go away within 2 weeks it is only because there was swelling that filled in everything even more than the filler and then the swelling went away. If this happens it’s possible that a touch-up of some more filler could get you back to that initial look.
When people come back at 6 months or 9 months or a year for more under-eye filler they usually can wait for a longer interval after the 2^nd treatment because filler on top of previous filler tends to last longer.
Ultimately some people are not ideal for under eye fillers, either because they have very large under-eye fat pads or a very tight under-eye crease where the dark circle resides. In these situations it’s best to consider surgery or accept that filler will only be a partial fix.
When you’re given expert advice, either filler under the eyes (some people call this the tear trough) or lower eyelid blepharoplasty surgery, the effect can be dramatic and almost life-changing while still keeping your face looking like it belongs to you.