The 1 filler this cosmetic surgeon is begging you not to get

In the past four years, cosmetic surgeon Dr. Giselle Prado-Wright noticed an uptick in younger, first-time clients asking for fillers.

She chalks the trend up to pandemic lockdowns and more time spent online. “You’re looking at yourself on camera, you’re seeing everybody perfectly filtered on social media,” Prado-Wright, the co-owner of EXERT BodySculpt in Florida, told Business Insider. “All of a sudden, you feel less than because you’re noticing a little bit of darkness, a little bit of wrinkles.”

Some of her clients in their early 20s initially come in for lip filler. Then they start asking for under-eye filler.

While Prado-Wright occasionally offers under-eye filler to help clients with “very sunken under-eyes,” she said she’s very conservative with how much she uses. Most of the time, she says no to under-eye filler because she believes that, at best, the results are usually very mixed — and that the greater risks are not worth it.

Short-lived Instagram Face

Like Botox and other fillers, under-eye filler is appealing to clients because there’s no downtime. “You might get some slight bruising, but compared to surgery, it’s not something where you have to do this big recovery, this big investment,” Prado-Wright said.

Under-eye filler also looks great right after injection. On social media, post-filler videos are usually shot a day or two after the treatment. “The problems come months down the line, maybe weeks later,” she said.

Fillers, which usually contain hyaluronic acid, draw in moisture. Over time, the under-eye area can become really puffy, with the fillers impairing lymphatic flow and potentially causing blockages.

“The immediate before-and-after is being propagated a lot on social media, versus ‘let’s see what that looks like a year from now,'” Prado-Wright said.

Risks include blindness and strokes

In the worst case scenario, Prado-Wright said under-eye fillers can pose serious health risks. If a syringe pokes the infraorbital artery, a significant blood vessel below the eyes, it cause cause blindness. It can also create a blockage called a vascular occlusion, which can lead to a stroke.

More likely, the filler will look amazing at first and swell later, she said. Ultimately, if the filler migrates or puffs up, it can be removed. But the process isn’t easy — or cheap.

The filler itself, at its cheapest, will cost you $500 to $600, she said — though it can cost up to $1,500.

The cost of getting it dissolved is charged per vial of Hylenex, a solution that dissolves hyaluronic acid. That can range from $250 to $600 per vial. Because the solution has to be injected exactly where the filler is, it can take multiple sessions to get rid of all of it.

Try tretinoin and lifestyle changes

Prado-Wright said she sees a lot of clients who keep wanting to add more filler. She tries to counsel them into dissolving some of it and looking for other anti-aging solutions.

One is using collagen injections instead of hyaluronic acid fillers. Collagen injections, made from cow collagen, are also used to add volume to the face and reduce fine lines.

Because collagen is naturally occurring in the skin and collagen injections have a thinner consistency than filler, there are lower risks of vascular occlusions or bad reactions, she said. Injecting collagen closer to the nose and cheeks can fill out the face and camouflage any under-eye hollowness.

She also suggested going to offices that offer other treatments besides filler, as under-eye concerns vary and can’t always be fixed with injections. Laser treatments can help with dark circles, for example.

Before you do all that, she said it’s worth making some simple skincare changes. You can try tretinoin, a prescription retinoid that boosts cell turnover. “It’s the gold standard just to help that skin quality look better, look brighter,” Prado-Wright said.

Of course, nothing will help if you’re not maintaining good sleep, decreasing your alcohol intake, and drinking enough water. “Not just your under-eyes are going to look better,” she said. “Your skin overall is going to look much better.”

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