Under Eye Filler or PRF? A Houston Nurse Practitioner's Guide
Home / Under Eye Filler or PRF
By Victoria Derdari, APRN, FNP-C, founder of Derma Theory Aesthetics Clinic and Academy, Houston. Reviewed September 2026.
The concealer that worked for ten years has stopped working, and you look tired in photos on days you slept well. So you searched “under eye filler Houston,” found a forum thread full of warnings about puffiness and a strange blue tint, and closed the tab. Nobody in that thread mentioned an option made from your own blood. I hear a version of that story most weeks, and it is why I wrote this guide.
Under eye filler suits a true hollow under good quality skin, when you want an immediate change and accept that this area is unforgiving of technique. PRF (platelet rich fibrin) suits thin, crepey, shadowed skin, when you want gradual improvement in skin quality using your own blood and nothing synthetic. EZ Gel, a gel made from your own blood, sits between the two.
Puffiness from fat pads and pigment based dark circles are not treated well by any of the three. A consultation at Derma Theory Aesthetics Clinic and Academy, a nurse practitioner owned and led regenerative aesthetics clinic in the Galleria area of Houston, is where we tell you which one you have.
Why Is the Under Eye Area So Hard to Treat?
The under eye area is hard to treat because the skin there is thinner than anywhere else on the face and because three different problems produce the same tired look. Shadow, pigment, and puffiness each have a different cause, and the cause decides the treatment.
The tear trough is the groove that runs from the inner corner of the eye down and outward toward the cheek. As the midface fat pads descend and the skin thins, the groove deepens and casts a shadow. Shadow is what injectables address.
Pigment behaves differently. If the darkness stays the same when you tilt your head back toward the light or gently stretch the skin, you are likely looking at color in the skin itself or blood vessels showing through it. Adding volume does not change skin color.
Puffiness is the third pattern. A bulge above the groove, often worse in the morning, is usually a fat pad or loose skin, and filling the hollow beneath it can make the bag more visible.
How Does Under Eye Filler Work, and What Are the Risks?
Under eye filler is a hyaluronic acid gel placed beneath the tear trough to lift the groove and soften the shadow, and the change is visible the same day. At Derma Theory we use Restylane, RHA, and Versa products, we apply numbing cream first for comfort, and under eye filler is $850. Results commonly last 12 to 18 months, and hyaluronic acid can be dissolved with an enzyme called hyaluronidase.
A 2023 review in Aesthetic Surgery Journal Open Forum (Woodward and colleagues) lists bruising, swelling, contour irregularities, and a bluish discoloration called the Tyndall effect among the commonly reported adverse events of hyaluronic acid filler around the eyes. The Tyndall effect happens when filler sits too close to the surface of thin skin and reads as blue through it.
Late swelling is the complication the forum threads are describing. The same review notes late onset lower eyelid swelling appearing weeks, months, or years after injection, often with no clear cause. Hyaluronic acid binds water and the under eye area drains fluid slowly, so some patients develop a puffiness that persists until the filler is dissolved. The area is also supplied by many small arteries, so the injector’s knowledge of anatomy matters more here than anywhere else on the face.
Under eye filler remains a good treatment for the right hollow in the right skin, placed conservatively. Downtime is 24 to 48 hours of possible swelling or bruising. Results vary.
How Does PRF Under the Eyes Work?
PRF (platelet rich fibrin) under the eyes uses a concentrate of your own blood to improve the thickness and quality of the skin over time, rather than filling space. We draw a small amount of blood, spin it in a centrifuge to concentrate the platelets and growth factors into a soft fibrin matrix, and place it under the eyes with fine injections after numbing cream has been applied.
Growth factors release from PRF steadily across roughly a 10 day window (Kobayashi and colleagues, Clinical Oral Investigations, 2016), which is why the change builds over the following weeks.
A 2025 systematic review of 14 studies in the Journal of Cosmetic Dermatology (Sollitto and colleagues) found PRF was associated with improvements in skin texture, wrinkles, and crepiness around the eyes, with only mild and short lived side effects, and that improvements often diminished by six months. That is why we plan PRF as a series with maintenance built in.
At Derma Theory, PRF under the eyes is $500 per session or $1,300 for a series of three, spaced three to four weeks apart. Downtime is 24 to 48 hours of possible swelling or bruising. There is no synthetic material, so there is nothing to dissolve and no Tyndall effect.
Every session uses both PRF and PRP (platelet rich plasma), and both are included in the price, as explained on our PRF page. The PRF Facial treats the whole face, including the under eye area, in one appointment.
What About EZ Gel Under the Eyes?
EZ Gel is the middle path: your own blood, processed into a gel that adds gentle structure under the eyes while stimulating your own collagen. We draw and spin the blood as we do for PRF, then take the concentrate through a controlled heating and cooling process that turns the liquid into a gel. Numbing cream is applied before the injections for comfort.
EZ Gel under the eyes is $800 for one area at Derma Theory, or $2,200 for three sessions on one area. Expect three to five days of swelling or bruising, which is longer than liquid PRF. Results commonly last several months, and a series is often recommended. Read more on our EZ Gel page.
Under Eye Filler vs PRF vs EZ Gel: How Do They Compare?
This table compares the three under eye options as we offer them at Derma Theory in Houston.
| Under eye filler | PRF under eye | EZ Gel under eye | |
|---|---|---|---|
| Source | Synthetic hyaluronic acid, made in a lab | Your own blood, in liquid form | Your own blood, processed into a gel through a heating and cooling process |
| What it does | Fills the hollow and binds water | Stimulates collagen, improves skin thickness and texture | Adds gentle structure while stimulating collagen |
| Onset | Immediate | Gradual, over the weeks after treatment | Gradual, over the weeks after treatment |
| Duration | Commonly 12 to 18 months | Builds over months. Maintenance sessions are commonly recommended | Commonly several months. A series of sessions is often recommended |
| Downtime | No to minimal. Swelling or bruising possible for 24 to 48 hours | No to minimal. Swelling or bruising possible for 24 to 48 hours | No to minimal. Swelling or bruising possible for three to five days |
| Reversible | Yes, with hyaluronidase | Not needed. Absorbed by the body over time | Not needed. Absorbed by the body over time |
| Price at Derma Theory | $850 | $500 per session, $1,300 for three | $800 for one area, $2,200 for three sessions on one area |
| Usually suits | A true hollow under good skin, wanting an immediate change | Thin, crepey, or shadowed skin, wanting gradual change with nothing synthetic | A mild hollow with thin skin, wanting structure without hyaluronic acid |
Results vary between individuals.
Which Is Right for Me?
The right under eye treatment depends on what is causing the tired look, so match your eyes to one of four patterns.
A hollow with good skin. The groove is visible, the skin over it is smooth and reasonably thick, and there is no bulge above it. This is the under eye that filler was designed for. EZ Gel is the alternative if you want to avoid hyaluronic acid.
Thin, crepey skin with shadow. The skin looks fine and papery, and the darkness is partly the skin itself. Filler under skin this thin is more likely to show or swell, so PRF is usually where we start, sometimes followed by EZ Gel once the skin has improved.
Puffiness or bags. A bulge from a fat pad or loose skin is not a hollow, and none of these three treatments removes it. We say so at the consultation, and if the honest answer is a surgical opinion, we say that too.
Pigment based dark circles. If the darkness is in the skin’s color rather than its shape, injectables that add volume do not change it. Evidence for platelet treatments on pigment is limited and mixed, so we do not promise it.
What Does a Consultation Involve?
An under eye consultation at Derma Theory applies the tilt and stretch test above in good light, with your whole face in view. We look at the hollow, the skin, the fat pads, the cheek beneath, and the pigment, and we ask what you have had done before, because prior filler in the area changes the plan. If filler placed elsewhere needs to come out first, we can dissolve it when appropriate.
Many patients arrive asking for filler and leave with a PRF plan, or hear that a small amount of cheek support would do more for the tear trough than anything placed directly under the eye. That change of plan is the point of the consultation. If you are pregnant or breastfeeding, have an active infection in the area, or have a bleeding or platelet disorder, PRF and EZ Gel are not appropriate, and we screen for this first.
How This Works at Derma Theory in the Galleria Area of Houston
Every under eye treatment at Derma Theory is performed by our nurse injector, in a practice founded and led by Victoria Derdari, APRN, FNP-C, an advanced practice registered nurse and board certified family nurse practitioner. You can verify her license with the Texas Board of Nursing. She is European trained, built the practice around facial balancing, and trains other injectors through Derma Theory Aesthetics Academy. Derma Theory holds more than 250 five star reviews on Google.
Pricing is plain: under eye filler $850, PRF or PRP $500 per session or $1,300 for three, EZ Gel $800 for one area or $2,200 for three sessions, and The PRF Facial $1,000 per session or $2,700 for three. Financing is available through Cherry, PatientFi, and Affirm. These treatments sit within our regenerative aesthetics practice, alongside dermal fillers for the rest of the face.
Under Eye Filler and PRF in Houston: Frequently Asked Questions
Is under eye filler safe?
Under eye filler is generally safe when a hyaluronic acid product is placed conservatively by an injector who treats this area often, but it carries more risk of visible problems than filler in the cheeks or lips. Bruising, swelling, a bluish tint, and persistent puffiness are the complications to ask about.
Does under eye filler make you look puffy?
It can. Hyaluronic acid binds water, and published reviews describe lower eyelid swelling appearing weeks, months, or even years after injection. Hyaluronidase can dissolve the filler if puffiness persists.
How long does under eye filler last?
Under eye filler commonly lasts 12 to 18 months, depending on the product and how your body handles it. Results vary.
Can under eye filler be dissolved?
Yes. Hyaluronic acid filler can be dissolved with hyaluronidase, an enzyme injected into the area. Dissolving may take more than one session and can cause temporary swelling of its own. We also dissolve hyaluronic acid filler placed by another provider when appropriate.
How much is under eye filler in Houston?
Under eye filler is $850 at Derma Theory in Houston. PRF under the eyes is $500 per session or $1,300 for three, and EZ Gel under the eyes is $800 for one area.
Does PRF get rid of dark circles?
PRF can improve the quality and thickness of thin under eye skin, which may soften shadow type dark circles for some patients. It is not a treatment for pigment in the skin, and no injectable addresses every cause of dark circles.
PRF or filler for under eye bags?
Neither. Under eye bags are usually a fat pad or loose skin, and neither PRF nor filler removes them. Filler placed below a bag can make it more noticeable. A consultation will tell you whether you have a bag or a hollow.
How long does PRF under eye last?
PRF under the eyes builds over the weeks after treatment, and a 2025 systematic review in the Journal of Cosmetic Dermatology found improvements often diminished by six months. Most patients plan a series of three and maintenance after that. Results vary.
Book an Under Eye Consultation in Houston
If you have read this far, I would rather you arrive with questions than with a treatment already chosen. Bring the photo that bothered you. We will look at the cause together and tell you plainly which option fits, including the option of doing less.
Derma Theory Aesthetics Clinic and Academy
3033 Chimney Rock Rd, Suite 105, Houston, TX 77056
Spanish translation assistance is available for consultations.
Written by Victoria Derdari, APRN, FNP-C. Results vary between individuals. This article is general information and is not medical advice.
Sources
- Sollitto CF, Narduzzi M, Wolinsky C. “A Systematic Review of Platelet-Rich Plasma Versus Platelet-Rich Fibrin for Periorbital Rejuvenation.” Journal of Cosmetic Dermatology, 2025, volume 24, issue 11, article e70524. doi:10.1111/jocd.70524. PMID 41190633. PubMed
- Woodward J, Cox SE, Kato K, Urdiales-Galvez F, Boyd C, Ashourian N. “Infraorbital Hollow Rejuvenation: Considerations, Complications, and the Contributions of Midface Volumization.” Aesthetic Surgery Journal Open Forum, 2023, volume 5, article ojad016. doi:10.1093/asjof/ojad016. PMID 36998744. PubMed
- Kobayashi E, Fluckiger L, Fujioka-Kobayashi M, Sawada K, Sculean A, Schaller B, Miron RJ. “Comparative release of growth factors from PRP, PRF, and advanced-PRF.” Clinical Oral Investigations, 2016, volume 20, issue 9, pages 2353 to 2360. doi:10.1007/s00784-016-1719-1. PMID 26809431. PubMed
