Why Lower Lid HA Fillers are a Terrible Idea

Injectable hyaluronic acid (HA) fillers are another type of derma filler that are commonly used under the eye to give plumpness thus reducing fine lines, wrinkles, bags, and dark circles. This works by retaining water at the site to plump up the area. HA is a component that does naturally occur in the body to retain the water. This is a common fact referenced as to why it works and why it is “safe”. Does this treatment work? Yes, initially. However, the results do not last and generally cause more problems down the line than you can imagine!

OK, so what happens?

Over time, the HA filler breaks down into shorter molecules from the long chain molecule that it is when first injected. These shorter molecules have more binding sites for water, therefore drawing in your bodies own natural fluid to the area, creating lymphatic draining blockage. This causes swelling in the area under the eyes, which can also be painful. This swelling can be intensified by things like allergies, sinus congestion, or from the foods you consume- like gluten, preservatives, excess sugar, alcohol, etc. Even upon waking up, your face can feel swollen, especially if you tend to sleep on your side, you will find that side is worse feeling than the other.

Here’s the thing, these HA fillers can stay in the body up to 12 years! There was a study done in Australia, where they took MRI’s of people’s faces and saw the HA filler up to 12 years later. That means your first 1-2 years may have great looking results with little irritation but the following 10? That’s when the problems set in as the HA filler breaks down. It’s important to understand, that once you have had filler under your eyes, this delayed complication can occur at any time. When this happens, it looks terrible as it draws in more water and swells up.

For some people, problems start to occur in as little as 6 weeks. Here at Perich Aesthetics, we recently had a women referred to us by a med spa who claimed she was having a bad allergic reaction to the treatment just 6 weeks later. Ultimately, this women should have never gotten the treatment done considering she had a history of allergy problems and was on medication to help alleviate them. Now, she will need different treatments to try and remove the HA filler and calm the area. This process will need multiple treatments and may not completely solve the problem.

What can be done to correct this and what are my alternatives to HA fillers?

It often takes multiple rounds of Hylenex injections to dissolve the HA filler, and there is no guarantee that you can ever get it all out. This procedure can cause bruising under the eye and on the upper cheek bone. It can also be done under ultrasound guidance to really try and get it all out.

After the injections are completed to correct the issue you can look at doing a permanent solution in a lower lid blepharoplasty with fat transfer (which ultimately should be the thing you do from day 1!). This surgery corrects the under eye hollows and dark tear troughs. If you have these concerns, this is actually a mid-face deficient and shows those tear troughs. The problem is not your under eye area- it is your mid-face! You need volume in the mid-face area (think your cheek bone) to support under the eye!

Additionally, you can consider Morpheus8 treatments which help boost the production of collagen. Doing this regularly will help maintain the mid-face volume. CO2 skin tightening treatments can aid in the area to help with the fine lines and wrinkles. These three options, Morpheus8, CO2 skin tightening, and lower lid blepharoplasty with fat transfer can correct this issue.

Why is Dr. Perich so passionate about NOT doing under eye fillers?

Dr. Perich, 4 years ago, actually had HA fillers done under her own eyes! The first 2 years, the results looked great but after that the area started to look “crappy”. Her personal journey with HA filler complications has made her passionate for others too. She says,

“Overtime the HA filler started to break down and be metabolized by my body which is completely normal, but as it breaks down in a smaller molecules, there are more binding sites for water which draws in fluid, creating swelling in that area. For me this swelling occurs first thing in the morning after I’ve been laying horizontally all night, and it’s worse on my right lower lid because I tend to sleep on my right side. It’s also worse if I sleep more than 6 hours, have any sinus congestion from allergies or a cold, or if I eat crappy foods or drinks (gluten, preservatives, excess sugar, alcohol, need I go on?). Fortunately I have cut out a lot of unhealthy food and drink choices over the years in pursuit of healing my leaky gut. Now knowing what I know, I would’ve just gone for a lower lid blepharoplasty with fat transfer from day one!

But I think God/Spirit/TheUniverse has a plan. I now understand my path is to experience this so I would become so passionate about it that I would help the rest of you out there who either have already gone down this path and need treatment, or if possible hopefully stumble upon this content before getting your under eye filler done and consider switching to doing a permanent surgical option instead. I hope you all know that I understand you more than you could ever imagine!”

If you are on any allergy medications, have any sinus issues- Do Not get HA Fillers! There are other options for you as stated above. Unless you have absolutely no history of swelling to anything or any allergy history, under eye fillers are NOT for you! Please feel free to schedule a consultation with us today to find the best possible solution for your unique needs.