Are Under Eye Fillers Safe? What San Diego Patients Should Know Before Treating Eye Bags

Written By Bright Eyes MD Team

If you’re researching San Diego under eye filler, you’re probably asking a very reasonable question:

Are under eye fillers safe?

The short answer is: under eye filler can be performed safely in experienced hands — but safety and long-term outcome are not the same thing. And that distinction matters.

Many patients who consider tear trough filler are trying to fix:

  • Under-eye bags

  • Dark circles

  • Hollowing

  • A tired appearance

But what most people don’t realize is that filler does not address the structural cause of these concerns.

Let’s break this down.

Why Do Under Eye Bags and Hollows Develop?

Under-eye aging is usually not caused by “missing volume” alone.

It typically involves:

  • Weakening of the membrane that holds orbital fat in place

  • Forward bulging of that fat

  • Midface descent (the cheek gradually lowers with age)

  • Shadowing between the cheek and lower eyelid

This is why adding filler can sometimes camouflage the area, but it doesn’t repair the underlying structural changes.

What Are the Risks of Under Eye Filler?

When performed carefully, tear trough filler can temporarily smooth hollowing. However, patients should understand several important considerations:

1. Filler May Persist Longer Than Expected

Hyaluronic acid fillers are often described as “temporary.” However, imaging studies have shown that filler can remain in the body longer than anticipated — sometimes years after injection.

Even when it appears to dissolve, residual material or water-binding effects may remain.

2. Filler Can Migrate

The under-eye area contains delicate tissue planes. Filler can shift from where it was originally placed, leading to:

  • Puffiness

  • Uneven texture

  • Fullness in unintended areas

When this happens, providers often recommend dissolving the filler, but…

3. Dissolving Filler Isn’t Always a Perfect Reset

Hyaluronidase is commonly used to dissolve hyaluronic acid filler. While generally considered safe, it works by breaking down hyaluronic acid… including your body’s naturally occurring hyaluronic acid in the area.

Some patients notice:

  • Thinner-looking skin

  • Crepey texture

  • Increased wrinkling

Once the delicate lower eyelid skin has been compromised, no surgical procedure can fully restore it to its original quality.

4. Tyndall Effect (Blue-Green Tint)

If filler is placed too superficially, it can create a bluish or greenish hue under the skin — known as the Tyndall effect. This is especially visible in the thin lower eyelid area.

Correcting this often requires dissolving the product.

So, Are Under Eye Fillers Safe?

From a procedural standpoint, tear trough filler can be safe when performed by a skilled injector.

But the more important question is:

Is it the right treatment for what’s actually causing the problem?

If the issue is structural — such as bulging fat and midface descent — adding filler does not correct the anatomy. It creates artificial fullness to mask shadowing.

For patients seeking the most natural and long-lasting improvement, addressing structure tends to produce more predictable outcomes.

What Is the Most Natural Way to Treat Under Eye Bags?

Instead of adding volume, Dr. Mark Garbutt and Bright Eyes MD recommend a more anatomical approach:

  • Securing bulging lower eyelid fat back under the eye

  • Restoring the cheek to a more youthful position

  • Preserving natural tissue rather than removing or adding material

By correcting the support structures instead of camouflaging them, the result tends to look more natural and age more gracefully.

This is fundamentally different from both tear trough filler and traditional transconjunctival blepharoplasty approaches that focus on fat removal alone.

Bright Eyes MD Team