Under eyes are an area of concern for many people! Hollowness, thin skin, and darkened skin all contribute to an appearance of fatigue, grumpiness, or just aging. Scrolling through Instagram, you’d think we could just throw some filler under your eyes and all those issues would be resolved! Well, it’s not that simple, unfortunately. This area of the face is really prone to changes depending on your hydration status, sleep, allergies, and salt intake. Sometimes under eye filler can look great at first, but shift over time and end up looking bulky, or make swelling appear worse! No one wants that! So let’s review some ways to actually improve the skin quality and under eye support so that you can have the best possible outcome! When patients come for consultation about under eye concerns we evaluate the structural support for the area. As we age, bone loss causes the orbit of the eye to get bigger, which makes the eyes look more sunken, increases hooding of the eye lids, and makes the under eyes look hollow. For the best outcome, we need to address those skeletal changes. We may suggest Sculptra (an injected collagen stimulating treatment) or filler to the cheeks and/or temples. Either Sculptra or cheek/temple filler can address the skeletal changes that lead to under eye hollows or deep tear troughs. To improve skin quality under the eyes, another treatment we often suggest prior to considering under eye filler is PRF injections. PRF stands for Platelet Rich Fibrin. For this treatment, we draw your blood in the office and spin it in a particular centrifuge to pull out the growth factors, stem cells, and white blood cells, and then reinject them under the eyes with a cannula. You’ll look puffy right away, but that PRF forms a matrix that breaks down slowly over about a week, gradually releasing those growth factors and stem cells. As your body responds to those healing components of your blood, the skin under the eye will develop a thicker dermis (the living layer of your skin), reduce fine lines, and improve color. The changes develop gradually over several months. Once we have addressed both the skeletal changes and skin quality contributing to under eye changes, then we reassess and see if we still need to use filler under the eyes! (Whew! It’s a process, right?!) Not every patient will need structural support or improved skin quality before under eye filler. There are some people who have a relatively simple under eye hollowing that can be adjusted pretty easily. At Synergy MedAesthetics, we will review all of these factors at your consultation. This helps us make a plan that is specific to you, your budget, and your time line. Ultimately, even though it might seem like an extra hassle or expense, we are committed to giving you an end result that looks natural and will stand the test of time, not just a simple fix that looks good for a few weeks. If you have questions about under eye treatments, you’re always welcome to schedule a complementary consultation at Synergy MedAesthetics!