Danger! - Filler Injections In The Eyelid To Remove Dark Circles Under The Eyes

November 11th, 2006

Recently I have received several reports of serious complications occurring in people who have had soft tissue fillers like Collagen and Restylane injected into their eyelids to correct dark circles under the eyes and other lower eyelid aging changes. Although the companies that manufacture the soft tissue fillers specifically recommend that Doctors not inject soft tissue fillers into the eyelid area, many Doctors are ignoring these warnings and injecting these fillers into the lower eyelid of patients to correct dark circles under the eyes.

So far patients have reported visible lumps on the eye and cheek area and significant swelling of the eyelids and have been told by their Doctors that nothing can be done to correct the problem. I fear much more serious complications such as injury to the eye.

Eyelid rejuvenation, that is correction of puffiness or bags of the lower eyelid and dark circles under the eyes are one of the most frequent complaints of patients seeking plastic surgery. The most effective and commonly recommended options to correct aging of the eyelid is a plastic surgery operation called a blepharoplasty . When properly performed by an experienced board Certified Plastic Surgeon on an appropriately selected patient, the blepharoplasty can safely produce excellent rejuvenation of both the upper and lower eyelids.

Many people however want to remove dark circles under the eyelids and rejuvenate the eyelid appearance but want to avoid surgery and are having soft tissue filler injections into the eyelid to plump up the dark circles. The theory is that if soft tissue filler is injected beneath the dark circle, the filler will plump up the dark circle and make it less noticeable. The technique can be successful but it is a temporary solution unlike blepharoplasty , which is a permanent solution.

The problem however is that soft tissue filler injection into the eyelid is, in my opinion, a potentially very dangerous procedure, and the companies that make the soft tissue fillers recommend against it.

The major risk is that the filler could be inadvertently injected into one of the blood vessels that feed into or drain the eyeball and if this were to occur the eye could potentially be injured and blindness could result. Worse, an inexperienced Doctor could inadvertently inject the filler directly into the eye causing serious damage.

In some cases the doctors who are doing soft tissue filler injections into the eyelid have had no training in surgery of the eyelids and do not possess the intimate knowledge of eyelid anatomy that is required to be doing invasive procedures on the eyelids. Even Ophthalmologists, the eye specialists use special care when injecting with needles around the eye.

The soft tissue fillers that are currently in use include Collagen, Zyderm, Zyplast, Hylaform, Perlane, Restylane, Radiesse, Sculptra, Cosmoplast, Cosmoderm, Evolence, and others.

Perhaps in the future controlled clinical studies will be reported which show the benefits and safety of injecting soft tissue fillers around the eyelid. For now, however, the reports I have had from patients who have had complications following this technique are an early warning and should be heeded.

I recommend that patients avoid this technique. If you have dark circles and puffiness under the eyes see a Board Certified Plastic Surgeon and consider a blepharoplasty. If you feel that you must have a filler injected into the eyelids then by all means see a board certified plastic surgeon or occuloplastic surgeon who has experience and knowledge in eyelid anatomy and surgery. If you have a complication you want to be under the care of an experienced Doctor who can take care of the problem.

Dr Seckel