Under-Eye Filler (Tear Trough Filler): Cost, Results and Risks

Under-eye filler, also called tear trough filler, is soft-tissue filler injected into the tear trough — the hollow that can form under the eye, in the area FDA approval records call the infraorbital hollow.

Adding volume to the depression softens the shadow it casts.

The two products approved here longest — Juvéderm Volbella XC (2021) and Restylane Eyelight (2023) — are crosslinked hyaluronic acid gels with lidocaine.

The regulatory picture is unusually narrow.

As of 2026-10-20, FDA approval records show four filler products with an approved under-eye (infraorbital hollow) indication: Juvéderm Volbella XC, Restylane Eyelight, Belotero Balance (+) Lidocaine, and RHA Redensity Eye / Eye Lido.

Using any other filler under the eyes — Restylane-L, Juvéderm Voluma XC, Radiesse, Sculptra, SkinVive — is off-label: that use is on no current US label for those products.

FDA's general dermal filler page, content current as of 07/06/2023, still lists the periorbital area — around the eyes — among uses "not approved by the FDA." That general page is outdated for the under-eye area: the product-specific infraorbital approvals above supersede it, which is why the area can only be called approved by naming the product.

Lower-eyelid bags and tear-trough hollows are different problems, and filler is designed for one of them.

A 2012 review in Aesthetic Surgery Journal explains that bags come from excess fat while a tear trough is a hollow; the two can occur together or alone.

Lower blepharoplasty — eyelid surgery — removes excess fat, whereas tear-trough treatments add volume to the depression.

Options for the hollow include hyaluronic acid filler, fat grafting, skeletal implants and fat transposition.

For bags specifically, see whether filler can fix under-eye bags.

Dark circles are a third problem again.

Galderma's own site promotes Restylane Eyelight to "correct dark circles," but Eyelight's FDA indication is improvement of infraorbital hollowing only — and Eyelight's own label warns that injecting the lower periorbital region in people with pre-existing pigmented dark circles may make discoloration more prominent.

What filler can change is the shadow a hollow casts, not pigment in the skin.

Our guide to skin and body concerns maps problems like these to the treatments that address them.

The label adds two limits worth knowing.

The Restylane Eyelight label warns that people with a pre-existing tendency toward edema may develop excessive swelling from fluid build-up after treatment.

And the approvals set an age floor: the four approved products are for people over 21 — 22 or older for RHA Redensity Eye.

Which of these — hollow, bag, pigment or a combination — is driving what you see in the mirror is an anatomy question for a licensed provider.

No study here crowns a best under-eye filler.

The one under-eye trial with published numbers on this page — Restylane Eyelight's — compared treated subjects with no-treatment controls, 287 treated against 46 untreated, rather than with another filler.

What FDA's premarket approval (PMA) records show is which products are approved under the eyes at all — and that list is short.

Everything else is off-label under the eyes, including fillers with long approval histories elsewhere on the face. Radiesse, a calcium hydroxylapatite (CaHA) filler rather than a hyaluronic acid one, has a label that states its safety and effectiveness in the periorbital (eye) area have not been established.

One date worth getting right: FDA approved Juvéderm Volbella XC for infraorbital hollowing on May 28, 2021.

If a clinic's marketing says 2022, that is the wrong year.

Under-eye filler is not priced per unit the way botulinum toxin typically is — per unit or per treatment area.

Allergan lists no prices on its Juvéderm FAQ; it says pricing varies by the Juvéderm product, the amount used and the provider, which makes the amount of filler used one visible driver of price.

For the full breakdown, see how much under-eye filler costs.

Under-eye amounts are small.

The Restylane Eyelight label limits treatment to up to 1 mL per side per session and recommends a follow-up session if more correction is needed, because the safety of larger amounts per session has not been established.

In the Eyelight trial the median initial volume for both hollows together was 1.2 mL, with 1.0 mL at touch-up; in a UK practice series of 1,452 applications in 583 patients, the mean first-visit volume was 0.34 mL per eye.

We could not find a published per-syringe price for any specific under-eye filler product, so treat any national figure you see with caution.

The broadest reference point is ASPS's cost page, which lists an average of $715 for hyaluronic acid fillers per its latest statistics — a national average physician fee per procedure, typically one syringe.

It is not an under-eye price, a med spa price or a quote for your case.

Galderma's ASPIRE rewards program earns points on qualifying Galderma treatments, which include Restylane products.

The clearest duration data we have for the under-eyes is the Restylane Eyelight trial's year of follow-up.

Blinded evaluators rated 87.4% of treated subjects responders at month 3, against 17.7% of untreated controls, and the share declined from there: 86.0% at month 6, 77.6% at month 9 and 63.5% at month 12.

A trial rate describes the group studied, not the result any one person will get.

To see what results can look like, see under-eye filler before and after.

Allergan's published claim for Juvéderm Volbella XC is that under-eye results can last "up to 1 year with optimal treatment." That is a manufacturer maximum — "up to" wording, often including touch-ups — not a label duration statement and not an average.

Two practical notes follow from the trial design.

The trial was built around more than one session — up to 3 treatments — and the median touch-up volume was 1.0 mL for both hollows together.

And the responder decline is gradual: the share rated improved barely moves between months 3 and 6, then falls at months 9 and 12.

Under-eye skin is thin, and the reaction numbers in trial diaries are high.

After the initial Eyelight injection, trial subjects' diaries most often reported tenderness (89.7%), swelling (85.0%), bruising (63.1%), redness (61.5%), pain (59.8%) and lumps or bumps (53.5%).

Swelling lasted 2 to 7 days for 76.6% of those who had it, and 14 to 28 days for 2.0%.

The median time until subjects felt comfortable returning to social engagement was within 4 hours for needle treatment and within 12 hours for cannula treatment.

These are figures from one product's trial diaries, not promises or limits for any individual.

The Eyelight label carries three under-eye-specific warnings: people prone to edema may get excessive swelling from fluid build-up; injecting the lower periorbital region in people with pigmented dark circles may make discoloration more prominent; and too-superficial injection in thin under-eye skin may cause contour irregularities, palpable lumps and a bluish discoloration.

That blue tint is what the literature calls the Tyndall effect, and the studies disagree on how often it happens: a 2023 meta-analysis of 31 reports (2,556 participants) puts blue discoloration or Tyndall effect at 0.9%, while a UK single-practice series of 1,452 applications found 3.3%.

The label itself gives no rate.

No single Tyndall figure transfers between studies, products or injectors.

The same two studies size the more frequent problems.

The meta-analysis found pooled rates of swelling 19.2%, bruising 18.4%, redness 7.1% and contour irregularity or lumps 5.3%, with 91.0% pooled satisfaction.

The UK series found 10% swelling with a median duration of 4 weeks, 4.6% contour irregularities, 4.3% bruising, and filler dissolved in 1.9% of orbits — and larger volumes were significantly linked to swelling and irregularities.

Some under-eye problems arrive late.

A 2021 review of periocular fillers reports that 90% of adverse events around the eye are mild and resolve within a month, but that malar edema — a delayed puffiness unique to the under-eye area — occurred in 11% of patients and can be managed with hyaluronidase when an HA filler was used.

A 2022 systematic review of 52 reported delayed cases found swelling most common (42.3%), then lumps or nodules (25.0%) and xanthelasma-like reactions (17.3%); the cases appeared a mean of 16.8 months after injection, with discoloration latest at a mean of 52 months.

The Eyelight label adds that late-onset inflammation or granulomas more than 2 years after injection are low in frequency but have been reported.

The serious risk is vascular.

Restylane's labels warn that rare ischemic events affecting the eye (vision loss) and brain (stroke) have been reported after facial filler treatments, and that many of the cases requiring medical intervention involved the glabella, nose and periorbital area — highly vascular sites that are outside those devices' indications.

Juvéderm's Important Safety Information warns that unintentional injection into a blood vessel, while very unlikely, can cause serious and possibly permanent complications — vision abnormalities, blindness, stroke, temporary scabs or permanent scarring — that most of these events are irreversible, and that the effectiveness of removing any dermal filler has not been studied.

When an HA result under the eyes needs undoing, the enzyme hyaluronidase can break hyaluronic acid filler down — including under the eyes, where oculoplastic surgeons note it is generally effective at reducing overcorrection or migration.

Dissolving filler is nevertheless not an FDA-approved use of hyaluronidase: the drug's own labels list three approved uses, and filler removal is not among them.

For more on problems after treatment, see what if under-eye filler goes wrong.

A concrete standard to ask about is Allergan's stated position on its own product: the company says Juvéderm Volbella XC should only be injected into under-eye hollows by doctors who have completed the necessary training for this treatment area, and its specialist finder marks trained doctors with a symbol.

That is a manufacturer's statement about its own training program.

It still gives you a concrete question for any consultation: what training have you had for the under-eye area specifically?

The questions that matter for any injectable matter doubly here, because the treatment site sits over thin skin and highly vascular tissue.

Before booking, work through the questions and red flags in our checklist: how to choose a med spa injector.