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Radiesse for Under Eyes
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If your patients complain of “puffy”, pronounced eye bags, dark circles or of constantly looking tired even if they are well-rested, they may benefit from dermal filler treatments.

How do dark circles and eye bags form?

Some dark circles may appear from sleep deprivation and will improve after a good night’s rest. But constant dark circles below the eyes that will not go away may be a result of a deformity of tear troughs. This is when there are contour irregularities in the areas right beneath the eyes, which cause or exacerbate shadowing in that area. Tear trough deformities can also result in the development of eye bags, which appear as puffy areas in the lower eyelid.

Tear trough deformities can be a result of genetics but can also be caused by aging. The descent of fat and skin due to the loss of facial elasticity and volume contributes to this condition, further exacerbating the situation. In these cases, filling the tear trough can help immensely.

Radiesse for tear trough treatment

Radiesse is a volumizing filler that also has the ability to stimulate the formation of collagen in the treatment area for long-term benefits. For patients who consider longevity of results a top priority, Radiesse may be a good choice of dermal filler. That being said, due to the physical characteristics of the filler, its use in the delicate tear trough region has been a matter of debate among practitioners. Clinical studies that evaluated the safety and effectiveness of this filler have suggested that Radiesse can be safely administered in the tear trough region with beneficial results, provided the injector uses proper techniques.

What is the procedure like?

The procedure for Radiesse injection differs slightly from injection with hyaluronic acid based fillers. Due to the thickness of the product, some practitioners prefer to dilute it beforehand with an anesthetic. In addition, it is important to note the deep placement of the product, which is required to avoid the formation of nodules.

Injection approach

The effective injection can be approached in two ways: by serial injection of 0.1ml microdroplets of the solution, or by linear threading. The first approach is preferable if the patient has very thin skin in the treatment area. This method uses a 27-gauge needle to administer small quantities of Radiesse spaced 1 cm apart in deep, vertical injections along a line about 1 cm beneath the lower orbital rim. If the patient has flat, medial cheeks, this is then followed with 1 or 2 additional lines, 0.5 cm beneath the initial line of injection. The second approach employs injection of the material using linear threading technique, injecting while slowly withdrawing the needle.

In all cases, overcorrection should be avoided. After administering Radiesse, the treatment area should be massaged gently. The patient should be advised to avoid touching the area unnecessarily, exposure to ultra-violet light, and using saunas, for at least 2 weeks.


Using a dermal filler such as Radiesse to fill in the tear trough region is a safe and effective way to improve the appearance of eye bags and under-eye dark circles. Patients may opt for Radiesse if they feel that long-lasting results is an important treatment factor.

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