Introduction

Let’s begin with the real question most people have but rarely ask out loud:

“Will under eye fillers make me look refreshed — or will I end up with puffiness, bruising, or that weird Tyndall effect I saw on Instagram?”

At Hugo Plastic Surgery in Gangnam, Seoul, we hear this concern every week. And it’s valid. The under-eye area is one of the most delicate parts of the face — and yet, it’s also one of the first places to show signs of aging, stress, or even genetics.

So are under eye fillers safe? Or are they a risky shortcut with unpredictable results?

Here’s the honest answer — from a plastic surgeon who performs this procedure regularly and sees the good, the bad, and the very swollen.

The Appeal of Under Eye Fillers

Before we talk risk, let’s talk reason.

The popularity of under eye fillers in Korea — and globally — stems from one simple truth: hollow or dark under eyes can make you look tired even when you’re not. Fillers offer a quick, non-surgical fix. In theory, it’s a lunchtime treatment that restores youthful volume in under 30 minutes.

But that simplicity is deceptive.

The under-eye region (also called the tear trough) is not just skin and fat. It’s a complex zone where bone, muscle, blood vessels, and lymphatics all converge — like the inner workings of a luxury watch. A small misstep here can lead to unexpected consequences.

How Do Under Eye Fillers Actually Work?

Under eye fillers use hyaluronic acid (HA) — a naturally occurring substance in the body that retains moisture — to fill the depressed area beneath the lower eyelids. When done correctly, this smooths the transition between the lower eyelid and the upper cheek, reducing the shadow that causes tired-looking eyes.

But it’s not just about “filling in the dip.”

What many people don’t realize is that the type of filler, injection depth, volume used, and angle of entry matter enormously. Unlike other facial areas, the under eye doesn’t tolerate imprecision.

“It’s like painting watercolor on rice paper,” says Dr. Seonghyeok Yang, lead surgeon at Hugo Plastic Surgery. “The canvas is so delicate that even a slight excess shows.”

The Safety Question: Is It Risky?

The short answer: Under eye fillers are generally safe when performed by a qualified, experienced professional.
The longer answer? It depends on several critical factors.

✔️ When It’s Safe:

• Performed by a board-certified plastic surgeon or dermatologist with anatomical expertise

• Use of low-viscosity, HA-based fillers (like Teosyal Redensity II or Restylane Eyelight)

• Minimal and precise injection techniques (such as cannula-based approaches to reduce bruising)

• Careful patient selection — not everyone is a good candidate

❌ When It Gets Risky:

• Injected too superficially → causes Tyndall effect (a bluish tint under the skin)

• Overfilling → leads to puffiness or festoons

• Inexperienced injector → increases risk of vascular complications

• Poor indication → fillers used where surgery (like lower blepharoplasty) is more appropriate

Common Side Effects (and How to Avoid Them)

Most patients experience minor swelling or redness for 1–3 days. Bruising can happen, especially if needles are used. But more serious issues — like lumpiness or prolonged puffiness — are typically the result of improper technique.

The 3 Complications We See Most Often (And How We Prevent Them)

1. Overfilling
   This is the most common aesthetic error. Patients may initially love the plump result, but weeks later, fluid retention or lymphatic blockage can create puffiness.

   At Hugo: We use conservative amounts and assess symmetry in real time. Less is more — especially under the eyes.

2. Tyndall Effect
   This bluish-gray shadow happens when HA filler is injected too close to the skin’s surface.

   At Hugo: We choose specialized fillers that integrate smoothly and inject them deeply enough to avoid this issue.

3. Migration or Irregular Texture
   Fillers can move or clump, especially if the patient rubs their eyes excessively post-treatment or if the filler isn't well integrated.

   At Hugo: We offer follow-up assessments and always provide post-care instructions tailored to each patient.

Is Surgery Better Than Fillers?

Here’s a truth many clinics won’t say upfront: Fillers aren’t right for everyone.

If you have:

• Significant under-eye bags

• Lax skin or poor skin quality

• Prominent festoons (malar mounds)

…then filler may only mask the problem temporarily — or even make it worse.

“In these cases, a lower blepharoplasty — often with fat repositioning — is the gold standard,” explains Dr. Yang. “It’s not about choosing filler or surgery. It’s about choosing the right solution for the anatomy.”

This is where experience matters. At Hugo Plastic Surgery, we often advise patients not to get fillers — even if they came in asking for them — because their facial structure or skin condition would respond better to surgical correction.

What People Often Overlook: Lymphatic Drainage

One under-discussed aspect is how fillers can impact lymphatic drainage. The under-eye has a relatively slow lymphatic flow. When filler is introduced — especially in high volumes — it can block this drainage and lead to prolonged swelling or “pillowy” eyes.

Think of it like a sponge sitting in a still puddle — without flow, water just sits there. This is why some patients look worse after filler, even with a technically correct injection.

So, Who Is a Good Candidate?

You're likely a good fit for under eye filler if:

• Your primary concern is volume loss, not fat bulging

• You have firm skin without much laxity

• Your tear troughs create a hollow or shadowed appearance

• You want a temporary, non-surgical solution

But even then, it’s not a one-size-fits-all treatment.

At Hugo Plastic Surgery, we assess facial balance, midface projection, skin texture, and even lighting before recommending filler. Because sometimes, what seems like an under-eye problem is actually a cheek volume issue, or even a lighting illusion.

Final Thoughts: Safe, Yes — But Only in the Right Hands

Under eye filler is one of the most technically demanding injectable procedures in aesthetic medicine. It requires not just training, but artistry — and restraint. When done well, it can shave years off your appearance, subtly and naturally. When done poorly, it can take months — and dissolving treatments — to recover from.

If you’re considering under eye filler, here’s our recommendation:

Don’t choose a clinic based on price. Choose based on precision.

Because the difference between natural and noticeable often comes down to a single millimeter.

Considering Under Eye Rejuvenation?

If you’re weighing filler vs. surgery — or simply want expert guidance on your options — consult with Dr. Seonghyeok Yang at Hugo Plastic Surgery in Gangnam.

We specialize in natural, high-quality results that enhance — not erase — your beauty.

Refreshed, not frozen. Balanced, not bloated.
That’s the Hugo approach.

📍 Visit us in Seoul or book a consultation today to explore your options with confidence.