Lara Adekola
Standing Appointment is our review series that investigates the best new and notable cosmetic treatments in the aesthetics space and determines whether or not they are worth trying for yourself. This week, one writer tries Restylane filler for under-eye bags.
At the tender age of 35, I noticed a major shift in my appearance: My under-eyes constantly looked fatigued. Despite getting a full night of beauty sleep, they had this sunken, saggy look that no amount of eye cream, serum, or brightening concealer could mask. Although I consider myself a confident person, I wasn’t ashamed to admit that it bothered me — especially when looking at photos of myself. Frankly, I was sick and tired of looking sick and tired. So I began researching tear trough filler, also known as under-eye filler, as a possible solution.
Skin care has always been my safe space for experimentation and when it comes to treatments, nothing is off-limits. I’ve had chemical peels, microdermabrasion, Hydrafacials, Botox, and even tried Moxi Laser — but the prospect of needles near my eyes was frightening. Did my under eyes really look that bad or was I just being my own worst critic? Am I doing this for vanity reasons? Is it that deep? Yes, in fact, it was that deep because it was affecting my quality of life and overall happiness. Aging is inevitable but how you age is a choice. After much due diligence, I booked an appointment with Dr. Michelle Henry, M.D., board-certified dermatologist, Mohs cosmetic surgeon, and founder of Skin & Aesthetic Surgery of Manhattan. She recommended Restylane filler as a viable and safe option to target the volume loss in my under eyes.
Read along for my first-hand experience getting under-eye filler, plus expert advice from Dr. Henry and New York-based dermatologist, Dr. David Kim, M.D of Idriss Dermatology, if you’ve been considering the treatment, too.
Who Is A Candidate for Under-Eye Filler?
Before diving into the miraculous benefits of Restylane, it’s important to note that not everyone is an ideal fit for the treatment. The perfect candidate? “Someone without hyperpigmentation but with darkness due to shadows, mid to severe hollows or sagging, and good skin elasticity,” says Henry. In other words, if you have chronic under-eye bags this treatment could be for you. However, there’s one concern under-eye filler does not solve: dark circles. “There are a lot of people who have dark circles primarily due to discoloration and vascularity, not necessarily volume loss which appears sunken in,” Kim tells TZR. “Filler will only help if there’s an actual volume loss.” For pigmentation concerns, it may help reduce the appearance of dark circles because any shadows diminish when the area is filled in. However, using targeted brightening products that contain active ingredients such as vitamin C, kojic acid, or retinol is your best solution.
Now is also a good time to address the elephant in the room. There’s a myth that “Black don’t crack” or Black women don’t get cosmetic enhancements — but it’s far from the truth. We’re investing in non-invasive cosmetic procedures at a higher rate than ever before. According to a 2020 study published by The American Society of Plastic Surgeons, post-pandemic there has been a rise in botox, fillers, and cosmetic surgery, with 1.7 million Black people undergoing cosmetic procedures, in comparison to 1 million a decade prior.
“We’re living in an era that’s embracing aging gracefully while also utilizing new technology to assist in this process,” Henry shares. “There is definitely an uptick in Black and brown women receiving filler as aesthetic enhancements have become less taboo and are more open to having treatments that augment their natural beauty.” I’d be remiss not to mention that this stigma played a role in my decision-making, but ultimately I had to do what’s best for me. “I’ve had patients as young as mid-20s receive treatment due to the severity of their tear trough area but I treat more women in their later 30s to mid-40s most often. Many Black women have flatter mid-faces due to some anatomical differences, so filling the mid-face is critical to attaining great results,” she adds.
What is Restylane Filler?
Restylane is a hyaluronic acid-based filler like most on the market (think Belotero or Juvéderm). However, its main point of distinction is a lower risk of filler migration and a low-irritancy formula that can minimize adverse reactions. “Restylane products have less hydrophilic properties so they’re less likely to attract or retain existing water in the body,” explains Henry. The Restylane family has a range of fillers that vary in firmness and elasticity, including Restylane EyeLight and Lyft. “There are different types of hyaluronic acid fillers. You have to find one that is very light and malleable so it blends in with the skin and doesn’t look bumpy or uneven. If someone has a lot of skin laxity in addition to lost volume, then I use Restylane-L,” Kim shares.
Furthermore, the amount of filler injected is equally as important as the type being used. There isn’t a one-size-fits-all answer. The dosage required is largely dependent on your facial anatomy and how vacuous the tear trough area is at the time. Typical filler syringes are comprised of 1 ml of filler, and patients usually receive 0.5 ml to 2 ml between the tear trough and mid-cheek. Most practitioners will agree that airing on the conservative side is best. “Usually you don’t need a whole syringe of filler. You kind of have to tailor it to that person’s specific needs. Less is more because it’s so easy to make it look strange, puffy, and bumpy,” advises Kim.
My under eyes before getting Restylane filler. | Courtesy of Lara Adekola
My Experience Getting Restylane Filler
My biggest fear was that I would end up with “filler face.” You know, swollen, puffy, and unrecognizable. I’d gone down a rabbit hole of under-eye filler gone wrong on TikTok and did not want that to be my fate. So I explained to Henry that I wanted my results to look natural and undetectable. She began with a thorough facial analysis, discussing benefits, concerns, and potential drawbacks, which instantly quelled my anxieties. To achieve the subtle tweak I desired, we landed on one syringe of filler split between both eyes, plus one syringe in the mid-cheek area for facial balancing. She next marked the injection points, sterilized the area, and applied numbing cream. Twenty minutes later, it was showtime. She reminded me to breathe and slowly inserted the needle into my tear trough. I told myself to stay calm and carry on — nothing was going to poke my eyes! Getting injected was the strangest sensation. I could feel the jelly-like fillers going into my skin and slight pressure for a few seconds, but overall the pain was minimal.
After administering the Restylane, Henry gently massaged it in place with her fingertips, confirming everything was set. The whole procedure was brief and took less than five minutes total. The effects are instant with little to no downtime, but it typically takes a full month for the filler to settle and the full results to set in. I glanced into the handheld mirror and saw the hollowness was gone. My under-eyes looked visibly tighter and lifted. I was shook. Henry sent me home with two ice packs and called it a day.
My under eyes pre-Restylane treatment. | Courtesy of Lara AdekolaMy under eyes immediately after receiving Restylane treatment. | Courtesy of Lara Adekola
The Potential Risks of Under-Eye Filler
Injections can be risky and it’s critical to know what they are before undergoing treatment. Common side effects include bruising, swelling, and redness immediately after receiving filler, which should start to subside within 24 to 72 hours. “We [dermatologists] always recommend patients to not drink alcohol the night before or 48 hours after. It reduces their risk of puffiness or bruising,” says Kim. Additionally, avoid certain medications such as aspirin, ibuprofen, and NSAIDS, as these blood-thinning agents can increase the chance of bruising post-injection. The full healing process can take anywhere from two to four weeks and varies from person to person.
In my case, it wasn’t until the next day that I started feeling the effects. I don’t typically bruise, however there was soreness, swelling, and slight discoloration near the inner corners of my eye. Although I initially panicked, these symptoms eventually subsided after three days.
My under eyes a few days post-treatment. | Courtesy of Lara Adekola
Since melanated skin is more prone to hyperpigmentation, Henry recommends using Alastin Inhance Post-Injection Serum to minimize any darkness. “It’s a TriHex technology-based product which promotes the production of new collagen and elastin while minimizing the look of swollen, discolored skin and speeds up bruise resolution.”
Going to a reputable injector is also key to preventing potential complications. “The most important precaution to take is to ensure you’re visiting a board-certified provider (plastic surgeon or dermatologist) with an extensive understanding of facial anatomy who regularly performs such treatment,” Henry warns. “Using an incorrect filler type can result in an unnatural appearance and/or skin damage, and there’s always risk for the treated area to become infected from needles.” Yikes. Albeit rare, blindness is the most serious possible risk and can occur if filler is inadvertently injected into a blood vessel. Moral of the story? Don’t mess around when it comes to your face.
How Long Do Restylane Results Last?
One month post-treatment, the filler finally settled and my results were jaw-dropping. It was as if someone waved a magic wand and erased my under-eye bags. Puffy eyes? Don’t know her. I looked like myself but better — well-rested, youthful, and refreshed. My skin was giving snatched with a soft airbrushed filter. I kept receiving compliments from friends saying my skin looked amazing, but they couldn’t put their finger on it. Well, the secret’s out if they’re reading this. The best part? I rarely wear makeup and when I do use concealer, it sets flawlessly. Fast forward six months and the filler still looks incredible.
My under eyes one month post-treatment. | Courtesy of Lara AdekolaMy under eyes six months post-treatment. | Courtesy of Lara Adekola
Hyaluronic acid-based filler typically lasts anywhere from six months up to one year. Since the under-eye area has slower metabolism compared to lip or cheek filler, some patients have reported two years’ worth of results. Just like any aesthetic treatment, touch-ups are a necessary part of maintenance. “I often recommend annual assessments to see if a patient needs re-treatment. I don’t re-treat blindly at one year as this is how patients often become overfilled,” says Henry.
My Takeaway
Now, for a little bit of girl math. Under-eye filler isn’t necessarily cheap. Prices vary based on geographic location and practitioner, but the average cost is $1000 to $1500 per syringe. Considering the seamless process, plus the amount of time and money saved on concealers and eye creams, in my humble opinion, it’s absolutely worth the investment. I love my results and do not regret the decision one bit.