Under-Eye Fillers: Depth and Volume Must Be Precise and Controlled

Many patients visit the clinic because they are often told they look tired even when they are well-rested, or because they are concerned about persistent dark circles. However, what appears to be a simple aesthetic concern—dark under-eyes—is often the result of far more complex anatomical factors.

The under-eye area is primarily composed of the orbital fat, the tear trough, and the midface. Changes in the position, volume, and elasticity of each of these structures contribute to the development of shadows and hollowing.

In particular, the tear trough is anchored by the orbicularis retaining ligament (ORL). When an imbalance develops between the upper orbital fat and the volume of the lower midface, deeper shadows can form in this area.

These shadows often create a much more tired appearance than the actual hollowing itself, making a person appear older than they are. I do not approach under-eye fillers simply as a way to fill hollow areas. Because this region is anatomically thin and highly complex, achieving a natural and seamless result requires precise control over the type of filler, particle size, viscoelasticity, and injection depth.

In patients with thin skin, the optical properties of the filler must also be carefully considered. If the product is injected too superficially, the Tyndall effect may occur, causing a bluish discoloration of the skin.

The aesthetic goal of under-eye treatment is not simply to eliminate hollowing, but to create a smooth transition into the cheeks, restore harmonious continuity between the cheekbone, under-eye area, and the side of the nose, and above all, achieve a naturally healthy appearance.

Before every procedure, I carefully evaluate the face from both the frontal and profile views, taking into account facial muscle movement and the overall skeletal balance when developing the treatment plan.

My philosophy regarding under-eye fillers has always remained the same. Although this is a treatment that adds volume rather than removes it, both the depth and the amount of filler must be precise and conservative. Regardless of the procedure, the most beautiful outcome is a face that looks naturally brighter and more refreshed—without revealing that a procedure has been performed.

Under-eye shadows are not simply the result of volume loss. Rather than trying to eliminate the shadow itself, my approach is to create a structure that allows light to be distributed evenly. That is the philosophy behind my approach to under-eye filler treatment.