Everything you need to know about non-surgical eye bag removal

How tear trough filler can minimise the appearance of eye bags and shadows


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In the past, going under the knife was the only aesthetic treatment for the removal of eye bags that many of us find problematic. However, in the last 10 years cosmetic doctors have invented new techniques to devise a non-surgical procedure, where dermal filler is placed deep beneath the under-eye muscle offering the same results as surgery, for at least nine months and often much longer.

Dr Nick Milojevic, one of the UK’s leading aesthetic doctors and owner of the Milo Clinic, was one of the first practitioners in the UK to practice this treatment. Now, his clinic carries out around 10-to-15 tear trough treatments per day. Below the expert tells Bazaar everything there is to know about this increasingly popular procedure that he feels is a real game-changer.

What are tear troughs?

“Tear troughs are depressions which run from the nose and all around under the eye. While some people may be born with a sunken look, others may notice tear troughs becoming more obvious as they age, a result of the skin sagging and the facial fat underneath depleting, leaving this concavity.”

What does the procedure actually entail?

“Non-surgical eye bag removal involves the use of a hyaluronic acid dermal filler, injected using a thin needle deep underneath the actual eye bag just above the orbital bone. With multiple puncture and threading techniques, the trough is then filled, lifting the under-eye area up. The treatment takes around 10-to-15 minutes, and the results are instantaneous although sometimes a follow-up treatment is needed.”

Who is the treatment suitable for?

“One of the main reasons we get eye bags is because over time we lose the volume in our cheeks, but this is not just a treatment for ageing concerns – many young people, both men and women, will be born with dark circles and deep bags and will still have them even if they’re getting eight-plus hours sleep per night. In this case we can treat under 18-year-old clients as long as we have consent. Women who are pregnant or breastfeeding are probably the only people we recommend don’t have treatment at that time.”

How can this procedure be preferable to surgery?

“The advantages of avoiding eye bag removal surgery are: no surgical scarring, no general anaesthesia, no overnight hospital stays, no time off work. In many cases the use of filler can have a more natural result than the surgical alternative. With filler you’re not taking anything away, unlike surgery where people can end up looking very different afterwards.”


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Is it painful?

“For some reason, people don’t experience much pain around the eye area, making it less uncomfortable than standard Botox injections. We use a numbing substance called lidocaine in the fillers, which can leave you with a temporary numb sensation afterwards.”

What are the side-effects?

“People will experience swelling and redness, but typically there’s no downtime. Very rarely people experience three-to-five days of swelling or bruising.”

How safe is the procedure?

“It’s a very safe procedure in the right hands, with the right doctor. We don’t recommend visiting a generic aesthetic clinics which advertise treatment offers, or perform the procedure at a discounted cost. Apart from some bruising and swelling there are some other rare cases of major side effects that include allergic reactions and infections, but a reputable and experienced doctor minimises these risks.”

How long do the results last?

“At least nine-to-12 months, but in our experience it can be two-to-three years or even more. Usually, if you have two syringes of filler on the first procedure, a year or two later just one syringe is needed, and then the gap between treatments gets longer and longer.”


What happens if you don’t like the results?

“If you are not happy with you results, there is an enzyme called Ryalase which can be used to literally melt the filler away. Given that the filler is hyaluronic acid-based, something that is naturally in the skin, over time it will dissolve on its own.”

What aftercare advice do you give?

“We recommend not doing any major exercise after the procedure, avoiding alcohol for 24 hours, and steering clear of any anti-inflammatory drugs which may thin the blood and produce further bruising. We sometimes recommend clients put some ice on the area, and on a rare occasion we may advise people take a steroid tablet to get rid of the swelling more quickly.”

How much does it cost?

“At Milo Clinic we charge £600 per syringe. Usually people need two syringes on the first treatment, but this really depends on the individual. And then a year, or 18 months later a follow up is needed which normally requires just one syringe. ”


03, October, 2019neekmilo_x186r333