The longevity of an under eyelid filler is dependent on several factors.
- Type of Filler
- Depth of the Injection
- Frequency of Injection
- Botox injection in conjunction with filler
- Individual metabolic rates of break-down of fillers
Type of Eyelid Fillers to Consider for Tear Troughs
To understand how long under eyelid fillers last, you first most understand that some facial fillers can be permanent, semi-permanent, or temporary. Typically I do not use or recommend permanent fillers around the eyelid skin. These include Radiesse, Bellafill, Silicone, and Artefill. These fillers are not reversible and may leave you bumpy with nodules. These fillers sometimes need to be removed surgically. There is no other way to remove them but sometimes the permanent fillers are so integrated into the tissues that they cannot be removed so my best advice is to avoid them as a cosmetic solution under your eyes.
Sculptra is a semi-permanent filler made of poly L lactic acid. This material when injected superficially can cause nodules so because it is unpredictable I don’t recommend using it around the eyelids either.
Fat injections surgically obtained from your hip and inner thigh or belly is exception to a long lasting “permanent” filler that can be used to fill in lower eyelids hollows. Fat when processed and injected in tiny quantities can be a very long lasting option. It too has some risks including granuloma formations but it does not have the advantages of lasting a long time. It is also possible that the fat can expand especially in hormonally active younger women.
Hyaluronic acid (HA) gels are a temporary but good choice in most people who want immediate gratification without having to undergo surgery, they are reversible if you get too much filler and in most cares are well tolerated. But not all HA fillers are the same. Juvederm and certain Restylane products are highly cross linked that can cause significant swelling and are difficult to reverse with hyaluronidase (an enzyme that breaks down H/As). Restylane is a great choice for under eyelid filling to reduce dark circles and under eyelid hollows. Restylane L can last anywhere between 6 months to 18 months sometimes longer.
How Long Should Filler Under Your Eyes Last
The longevity of any filler can depend on an individual ability to metabolize (or breakdown) the filler. Some people metabolize the filler very quickly and therefore the benefit is shorter compared to other pole who slowly break down the filler. There is no test to determine if you are a fast metabolizer or a slow one. I have found that this people people in general break down the filler faster. Which makes sense because their overall body metabolism is higher because they don’t gain weight easily.
Filler Injector Technique & Impact On Cosmetic Outcome
Some people wonder whether the injecting techniques can determine how long an eyelid filler will last. The answer is yes. If a filler is impacted deep within the lower eyelid it is less likely to cause an irregular bumpy surface problem however a deeper injection will probably be absorbed more quickly because the blood supply surrounding the material is greater and there it is likely to be reabsorbed more quickly.
The location on the face where a filler is injected can also determine how long it lasts. For instance injections around the mouth generally last between 6-9 months. This is because you are talking, chewing, and smiling all day long which mobilizes the filler and it gets absorbed more quickly. In comparison the lower eyelid does not move as much and therefore the filler in this area tends to last longer, sometimes up to 18 months.
Some people wonder if they need as much H/A filler every time they come in. The answer is that they probably do not. Overtime the filler itself can lead to a new collagen formation. This can occur due to the “ballooning” effect of the filler which actually stimulates collagen deposition and the filler itself can cause low grade inflammation which will result in collagen repair. So overtime you will probably need less filler to accomplish you aesthetic goals.
Benefits of Botox with Eyelid Facial Fillers
Lastly, some people ask if there is any other way to prolong the benefit of lower lid fillers in the tear troughs? The answer is yes. Botox inhibits the contraction of muscle so if Botox is used in conjunction with the lower eyelid hyaluronic acid filler there will be less movement of the muscles around the eyelids which will allow the filler to last longer.
