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Under Eye Fillers with Dr. Jaffer Khan

Dermal fillers are amongst the most popular aesthetic treatments as they offer quick results with minimal downtime.

For this month’s topic of our “5 Minutes with Dr. Jaffer Khan” section, we chose to focus on under eye fillers, also know as tear trough fillers.

Patients who are good candidates for this treatment often complain of a ‘hollow look’ or dark circles under their eyes; they may also point out enlarging fat pockets in the lower eyelids.

We asked in house plastic surgeon at Aesthetics, Dr. Jaffer Khan, to offer his expert advice on a number of FAQ’s related to this popular aesthetic treatment.

Q. What makes a good candidate for an under eye filler procedure? 

Dr. Khan: People who have trouble with dark circles under the eyes as well as people who want to improve the contour between the cheek and the lid junction. There is sometimes a depressed crescent under the eye, which shows aging or tiredness, and such people are excellent candidates for this procedure. It is also desirable that there is no skin excess; in other words, tauter skin would give a better result. Any age group can have this, and some degree of  result can be achieved, but obviously, the less skin excess, the better result you can have.

Q. How is an under eye filler procedure performed? 

Dr.  Khan:  The  patient  has  the  procedure  done  under  local anesthetic cream, which is called EMLA cream, applied to the area about half an hour before the start of the procedure. All the procedural details and potential complications are explained to the patient beforehand, and the procedure starts with the patient gazing forward and sitting on a reclining chair. It is quite painless. A series of injections are given in the periocular area, and then, some cold packs are applied.

Q. What are the realistic results that I can expect?

Dr. Khan:The procedure is usually carried out in two stages. The first stage being done initially with a larger quantity of volume placed underneath the eye, and for the first 48 hours, the area can be a little bit swollen, and there can be occasional bruising. Apart from that, the results are immediately visible, and if the fillers are placed judiciously and with proper quantity, the results look very natural and pleasing.

Q. Do you have before and after photos I can look at for this procedure?

Dr. Khan:Yes, we always keep Before and After photos for patients to get an idea of what type of results they can expect, and there is a wide variation of the age groups that we have done as well.

Q. What kind of recovery period can I expect, and when can I resume normal activities?

Dr. Khan:As mentioned, the recovery period for this is just 3 to 4 days, and this is predominantly a social issue to get rid of the swelling and whatever little bruising there may be. Normal activities can be resumed on the following day.

Q. What are the risks and complications associated with my procedure?

Dr. Khan:As with all fillers, the risks are essentially those which can be associated with any injection of a needle into the body; infection, bruising, bleeding, as well as allergic reactions to the filler substance.  In this case hyaluronic acid, which is a natural filler and one that can be dissolved within 24 hours is used, and here, it is very biocompatible with very few side effects.

The most severe side effects of periocular fillers, and indeed fillers anywhere on the face, are vascular ones where inadvertent injections into an artery or a vein can lead to complications  such as prolonged  swelling,  edema,  redness, and indeed even permanent loss of eyesight.   The latter is obviously  quite  scary  for  a  number  of  patients  to  know about,  but  we  have  to  be  sure  that  all  potential complications  are mentioned to the patients, as this is only fair to do.  The risks however, are very, very, small indeed -­? there have only been a few cases worldwide reported.  All precautions  are  taken  to  avoid  this  complication  by repeatedly  pulling  back  on  the  syringe  plunger  to  ensure that it is not in a vessel and to inject also very slowly.

Q. How long will the results last?

Dr. Khan:Under eye area is unique in that the results can last from a year up to 3 years.  Although a small top-up may be required from time to time, but no sooner than 8 to 10 months.

Q. Any other advice?

Dr.  Khan:  Yes, it is important  to have a consultation  with your practitioner and to ensure that there is confidence in creating  a natural result without any lumpiness.   It is very important  that the correct  plane  be found  in placement  of this filler, as placing it too superficially in this area with very thin skin can result in unpleasing results.

About your surgeon:

Dr. Jaffer Khan is the director and head consultant at Aesthetics International. A former Consultant Plastic Surgeon in the United Kingdom, he did his initial plastic surgical training at Cork University Hospital in Ireland before moving to the UK.

He is a member of and affiliated with: American Society of Plastic Surgeons Royal College of Surgeons in Ireland, England, Glasgow, Wales, International Society of Aesthetic Plastic Surgery, American College of Surgeons, The American Society for Aesthetic Plastic Surgery, The British Association of Aesthetic Plastic Surgeons.

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