Dark circles have more than one cause
The tear trough is the groove running from the inner corner of the eye along the socket. When it deepens, it casts a shadow that looks like a dark circle. Filler is aimed at that shadow. It does nothing for dark circles with another cause.
Gel on the bone is placed at the groove that casts the shadow. It does not act on the skin itself. If your darkness has more than one cause, filler may help only part of it.
So the first step is working out which type you have. A simple clue is the stretch test. If the circle fades when you stretch the skin gently sideways, the cause is likely structural or vascular. Dr Sin Yong then confirms this on examination, because filler on the wrong cause can make things worse.
Four causes, four routes
| Cause | What it looks like | Route |
|---|---|---|
| Structural hollowing | A concave groove that casts shadow | Hyaluronic acid filler may be considered |
| Pigmentation | Colour in the skin itself | Pigment-directed laser assessment, since volume does not change melanin |
| Vascular shadowing | Vessels showing through | Vascular laser assessment, not filler |
| Fat prolapse | A convex bulge of orbital fat | Eye bag assessment, with blepharoplasty or laser protocols. Filler makes this worse |
Why a hollow and a bag need different plans
A hollow is concave, while a true eye bag is convex, formed by orbital fat pushing forward. Placing gel beside a bulge adds to the bulk, so the area can look fuller, not smoother. A bag needs surgical assessment or specific laser protocols. Skin laxity can also play a part in dark circles, and it is looked at separately.
Who under-eye filler may suit
It runs along the orbital rim and looks like a groove.
The skin over the hollow is reasonably firm. Very thin, crepey skin argues against filler.
Nothing is bulging above the groove, as filler would add to a bag.
The darkness comes mainly from the hollow. If colour dominates, laser is the route.
The Tear Trough Refinement Protocol
Where the gel sits
Gel goes deep, on the bone and under the orbicularis muscle. The entry point is kept away from the infraorbital foramen and the angular vessels. Very small amounts are placed while the contour is watched, then moulded by hand. Working in very small amounts lets the contour guide when to stop. Depth matters because superficial placement risks a bluish tint, the Tyndall effect. Non-hyaluronic fillers are not used here, because they cannot be dissolved. A topical anaesthetic may be applied, and most products used here contain lidocaine.
Who should wait or avoid it
Prominent eye bags, malar oedema or festoons, very thin crepey skin, pigment-led dark circles, and past over-filling. Earlier over-filling is a reason not to add more.
Pregnancy, breastfeeding, active infection, cold sores, or inflamed skin near the eyes.
Allergy to hyaluronic acid products or lidocaine, past filler reactions, autoimmune conditions, a bleeding tendency or blood thinners.
It must be identified, and ultrasound may be used. It is often dissolved before a new plan starts.
What under eye filler in Singapore cannot do
Filler does not alter melanin. See pigmentation removal.
Vascular shadowing is treated with laser, not volume.
It cannot dissolve or shrink bulging orbital fat, and surgical assessment may be needed.
It sits on the bone, so the skin itself stays the same.
Risks to discuss
Bruising and swelling are common. A cannula is used to limit them, but risk remains. Lumps or irregularity can come from high-viscosity products or shallow placement. Overcorrection can leave a shelf, puffiness or a pillow look. Other risks are the Tyndall effect, malar oedema and prolonged swelling. Vascular occlusion is rare, but it can affect vision. Problems are seen more often when the wrong product, depth or amount is used, which is why each of these is fixed in the protocol. Hyaluronic acid can be dissolved with hyaluronidase, but no technique removes risk.
Recovery and warning signs
Swelling, tenderness and a pinpoint bruise at the entry point are normal. The area may feel slightly firm or uneven while the gel settles. Cold compresses, sleeping with your head raised and keeping pressure off the area all help. Pale, mottled or dusky skin needs immediate review. Pain that increases instead of settling also needs attention. Any change in vision is urgent and means emergency eye care. A lump or blue line that lasts past the swelling, or a red, warm, tender lump appearing weeks later, should be examined, not massaged. Read our warning signs and filler aftercare pages.
How long it lasts, and fees
There is no fixed duration. It depends on the product, amount, depth and how you break the gel down. The final result is judged after swelling settles. Maintenance follows what is found at review, not a set schedule. Fees are given at consultation after assessment, because a quote given before examination is for a treatment not yet planned. They depend on the product, quantity, whether the cheek is treated too, whether earlier product must be dissolved, and any combined treatment. See how we quote.