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Heather Hanks
Written by Heather Hanks

Reviewed by Physician Kelvin Goh and Dr Jessica Gunawan on January 9, 2023

Here’s What You Need To Know Before Getting Dermal Fillers

Published | 6 min read

Are you considering getting dermal fillers? Before you do, read this guide on tips to help you recover as well as natural remedies that may work even better.

Dermal fillers min scaled

The demand for non-invasive cosmetic procedures, such as dermal fillers, has been on the rise in the United States.

  • The dermal filler industry is expected to rise from $5.31 billion in 2022 to $8.74 billion by 2029. This is an increase of 7.4%.
  • Dermal fillers can be used to correct wrinkles and facial lines, restore lost volume, reduce acne scars, and enhance the lips.
  • Despite being relatively safe, there are still some risks associated with the procedure. Additionally, dermal fillers are not for everyone.

Are you thinking about getting dermal fillers? Read this guide to learn about the potential benefits, risks, and alternatives. Then decide whether they are right for you.

What Are Dermal Fillers And What Do They Do?

A woman getting dermal fillers under her eyes
Dermal fillers can be used to treat under-eye bags.

In conventional medical understanding, under-eye bags, dark circles, or wrinkles under the eyes aren’t deemed as medical concerns.

However, these so-called imperfections can negatively affect the emotional health and psychological well-being of those who are bothered by the way they look. 

The tear trough is the space below the eyes and the cheeks that can lose its volume and brightness over time, giving the appearance of under-eye bags or dark circles.

A few different cosmetic procedures can potentially combat deep and saggy tear troughs. Dermal fillers are one of the more popular cosmetic procedures.

  • Dermal fillers are substances that can be injected into several sites along the tear trough to fill in the area and plump it up again.
  • Different compounds are used as dermal fillers, with hyaluronic acid being one of the more popular options.
  • Others that may also be used for tear troughs include calcium hydroxylapatite and poly-L-lactic acid.

Results are temporary but immediate

Dermal fillers, especially hyaluronic acid fillers, are among the most non-invasive cosmetic options for sagging tear troughs.

A trained and expert medical professional will clean and ice your tear troughs and inject the filler using prefilled syringes. Results are immediate, and 95% of patients indicate feeling highly satisfied with the results. 

However, dermal fillers are not permanent. They last between six months to about two years, depending on the type and brand of filler used. Your body eventually absorbs fillers. 

Dermal fillers are not for everyone

It is important to work with a medical professional who is an expert in dermal fillers first to ensure what type of filler is right for you and whether you are a suitable candidate for the procedure.

People with the below conditions are contraindicated from undergoing dermal filler injections

Possible Side Effects Of Dermal Fillers

Despite being low, the risks of severe side effects resulting from dermal filler procedures are not zero. One side effect is a granuloma. This occurs when there are small areas of inflammation that form around the injection sites.

Another possible side effect is vascular occlusion, which occurs when blood cannot pass through a blood vessel where the filler was injected. This results in structural changes and discoloration, leading to possible tissue death (necrosis) and blindness. 

If you decide to get a dermal filler, you may want to consider a medical clinic or hospital rather than a spa. Healthcare professionals in medical settings are required by law to have medical expertise.

Best TCM Alternatives To Dermal Fillers

High antioxidant foods such as blackberries, blueberries, cherries, and raspberries pictured on white plates
Eating foods that are high in antioxidants can help slow down the skin aging process from the inside out.

Instead of external cosmetic enhancements, you may want to consider a more natural approach to keeping under-eye bags at bay.

We spoke with Real Medical Physician Kelvin Goh on the Traditional Chinese Medicine (TCM) point of view when choosing between tear trough fillers and a more natural approach. 

“TCM strongly believes in treating illness from the root cause. As fillers are not permanent and your body absorbs them within months, you’ll need to continuously inject fillers will to stay youthful. We believe in aging gracefully by working on the body internally, targeting the root cause, and slowing down the aging process.”

TCM Physician Kelvin Goh

In TCM, practitioners use the following framework of five “wheels” to diagnose disorders of the eyes: 

  • The wheel of flesh: Associated with the Spleen, which correlates to the flesh around the eyes 
  • The wheel of blood: Associated with the Heart, which correlates to the inner and outer canthus (corners) of the eyes where the upper and lower eyelids meet  
  • The wheel of qi: Associated with the Lungs, which correlates to the sclera (the white of the eye)  
  • The wheel of Wind: Associated with the Liver, which correlates to the irises  
  • The wheel of Water: Associated with the Kidneys, which correlate to the pupils  

Physician Goh shares that puffy, tired eyes with dark circles usually stem from a Spleen Dampness or Spleen Qi (life force) Deficiency through this framework.

“The Spleen‘s main function is to transport and transform body fluids. Dampness in the Spleen causes it to lose these functions, leading to an accumulation of moisture within the body, causing the eye bags to look puffy and heavy.”

TCM Physician Kelvin Goh

He also adds that the Spleen governs muscles and has an uplifting effect on our body. If the Spleen is experiencing Qi Deficiency, this will cause eye muscles to sag, speeding up aging. 

Start treating saggy under eyes before you need dermal fillers

When asked what advice he would give for a youthful complexion, Physician Goh advises starting health and beauty maintenance and preservation as early as in your mid-twenties.

“Regular TCM maintenance will allow us to deter or repair the damages that we have done to our body via external factors like weatherstress, and internal factors like the aging process.”

TCM Physician Kelvin Goh

Consider using a skincare cleanser and moisturizer made with gentle ingredients that help firm skin without irritating it. Applying sunscreen before going outdoors can help protect skin against sun-induced wrinkles and sagging.

Use both internal and external TCM remedies 

A young woman performing gua sha massage under her eyes
Gua sha massage is a natural alternative to dermal fillers that can help smooth out under-eye bags.

TCM offers internal and external options for health and beauty maintenance. Herbal medicine and superfoods can be consumed for internal well-being while acupuncture involves external needles along meridian pathways to affect internal workings.

“Facial gua sha is a TCM facial treatment that uses a flat jade or porcelain tool over the face in an upward stroke to smoothen the fascia and relax the tired face muscles. This will promote tissue drainage.”

TCM Physician Kelvin Goh

Benefits of gua sha massage include:  

  1. Clearer skin
  2. Reduced appearance of eye bags
  3. Facial muscle tension relief
  4. Improved skin elasticity

Embrace Aging Gracefully

Dermal fillers can provide an immediate but temporary improvement in saggy tear troughs. On the other hand, natural alternatives and remedies have long-lasting effects.

“By diagnosing, understanding, and working on your health, you can prolong the aging process. Aging gracefully is the key, as aging is inevitable,” shares Physician Goh.


  1. Market Research Report. 2022. The global dermal fillers market is projected to grow from $5.31 billion in 2022 to $8.74 billion by 2029, at a CAGR of 7.4% in forecast period, 2022-2029
  2. Cleveland Clinic. 2022. Are Tear Trough Fillers Effective for Undereye Bags? [online] Available at: <https://health.clevelandclinic.org/is-tear-trough-filler-safe/
  3. Annals of Dermatology. 2018. Treatments of Infra-Orbital Dark Circles by Various Etiologies. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992473/
  4. Johns Hopkins Medicine. Dermal Fillers. [online] Available at: <https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/dermal-fillers
  5. Journal of Cosmetic Dermatology. 2021. Recommendations for the treatment of tear trough deformity with cross‐linked hyaluronic acid filler. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818415/
  6. ScienceofBeauty.net. 2021. Ask A Dermatologist: Do Gua Sha Facials Really Work? [online] Available at: <https://www.scienceofbeauty.net/ep19-does-gua-sha-really-work/
  7. The Journal of Clinical and Aesthetic Dermatology. 2014. Improvement of Tear Trough by Monophasic Hyaluronic Acid and Calcium Hydroxylapatite. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217290/
  8. Plastic and Aesthetic Research Journal. 2020. Complications after cosmetic periocular filler: prevention and management. [online] Available at: <https://parjournal.net/article/view/3605

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