Under-eye filler: what the FDA says about tear trough and under-eye hollow injections

Filler is used to soften hollows under the eyes. The FDA's pages disagree on this area: one lists under-eye hollows among the approved uses of dermal fillers, and another lists the area around the eyes among uses the FDA says are not approved.¹²

Here is what each page says, the risks and what to ask. It gives no dose and no technique. Whether to have it is for you and a clinician.

What the FDA says

The FDA's consumer update says dermal fillers are approved for specific uses in people aged 22 and older, and lists increasing fullness of the lips, cheeks, chin, under-eye hollows, jawline and back of the hand.¹

The FDA's device page lists, under uses it says are not approved, injecting the glabella (the area between the eyebrows), the nose, the periorbital area (around the eyes), the forehead or the neck.² It says the FDA recommends against those.

Neither page says which products it means. Ask your provider which filler they would use, and whether it is approved for that area.

What it is for

The plastic surgeons' society lists decreasing or removing the shadow of the lower lids among the things dermal fillers can do.⁴ Dermal fillers are gel-like substances injected under the skin to create a smoother or fuller appearance. The FDA regulates them as medical devices, and they are prescription-only.¹³

The risks to ask about

Common risks include bruising, redness, swelling, pain, tenderness, itching and rash. Most appear shortly after injection and many resolve in days to weeks, though in some cases side effects emerge weeks, months or years later.¹

The most serious risk is accidental injection into a blood vessel. The FDA says that can cause skin necrosis (death of tissue), stroke or blindness, and that while the chance is low, the complications can be serious and may be permanent.¹ Because the eyes are close, ask any provider what they would do, and who you would call.

Filler can be hard to take back. The FDA says you may need further injections, surgery or other procedures to reduce or remove it, that these have their own risks, and that for some materials it may be difficult or impossible.¹²

Who injects, and what is in the syringe

The FDA's advice is a licensed provider who has experience in dermatology or plastic surgery and is trained to inject dermal fillers, using properly labeled, sealed vials or pre-filled syringes of FDA-approved filler. It also advises requesting and reading the patient labeling.¹ The FDA warns against fillers sold directly to the public, which may be fake, contaminated or not approved in the US.¹³ Our lip filler provider guide goes through those checks.

Which licensed professionals may inject depends on your state. See our guide to who may inject.

Here is what to bring to a consultation.

Cost

We don't give prices on this page. Our lip filler cost guide shows how clinics quote filler, per syringe.

Common questions