Patients considering treatment for tired-looking under-eyes often arrive with a long list of questions, and it is one of the areas where a single product rarely tells the whole story. What is actually being injected? Is it filling the hollow, or doing something else entirely? What should recovery look like? These are reasonable questions, and they deserve a clear answer rather than a marketing term.
This article answers the questions Dr Rami Haidar is asked most often about a hybrid treatment he uses for under-eyes and lifting at Excellence Medical Boutique in Jumeirah, Dubai, one that combines two ingredients working in different ways rather than relying on a single mechanism.
Dr Rami Haidar | 27th July 2026 | Excellence Medical Boutique, Dubai
The treatment combines poly-L-lactic acid, known as PLLA, with hyaluronic acid, known as HA, in a single formulation used under the eyes and for lifting. Rather than relying on one ingredient to do everything, the combination is designed so that each component contributes something different to the result.
The formulation contains PLLA alongside hyaluronic acid. PLLA is a collagen biostimulator, a substance with a long history of use in medicine that works by encouraging the body’s own tissue to produce new collagen over time. HA is the same hydrating, volumizing ingredient used in many dermal fillers and skin boosters, and here it contributes to that immediate, structural part of the result.
Because the treatment contains two different ingredients, it works in two different ways. The hyaluronic acid component helps fill the area, providing a more immediate improvement in volume, while the PLLA component works over time to help rejuvenate the skin by encouraging collagen production. Dr Rami describes PLLA specifically as a bio-stimulator, meaning its role is to prompt the tissue to rebuild itself gradually rather than to add volume on its own.
This is why the treatment is often described as doing two jobs at once, filling in the short term and supporting the skin’s own structure over the following weeks and months.
A standard hyaluronic acid filler is designed primarily to add volume and support contour in a specific area, and its effect is largely present from the moment it is placed. A hybrid treatment like this one still uses hyaluronic acid for that immediate structural benefit, but it pairs it with PLLA specifically because volume alone does not always address the full picture under the eyes.
Under-eye hollows are often the result of both lost volume and a gradual decline in the skin’s own structural quality. Filler alone can address the volume side of that equation, while the PLLA component is included to work on the skin quality side over time. This is the same reasoning behind Dr Rami’s broader approach to treatment planning, matching what is used to what is actually causing the concern rather than defaulting to one product for every patient.
Because the treatment is injected, a little bit of swelling in the treated area is a normal and expected part of the process. Patients are also often told to expect a noticeable amount of lifting as the combination takes effect, though the balance between the immediate filling effect and the gradual biostimulating effect varies from patient to patient.
As with any injectable treatment, individual healing and results depend on the patient’s own skin and anatomy, and mild swelling should be expected to settle within the normal recovery window rather than persist.
Patient feedback on the treatment has generally focused on comfort during the procedure and visible improvement in areas such as smile lines, with many patients reporting that the injection itself was more comfortable than they expected. As with any patient experience, individual comfort levels vary, and this is something worth discussing directly during consultation.
Aftercare for this treatment is straightforward. Patients are generally advised to stay well hydrated in the days following treatment, since supporting the body’s own tissue response is part of how the biostimulating component works. A second session is typically scheduled around a month later, allowing the practitioner to assess how the treatment has settled before deciding whether further treatment is needed.
This staged approach is intentional. Because the PLLA component works gradually, results are usually best judged over a series of sessions rather than immediately after the first appointment.
Patients whose main concern is tired-looking or hollow under-eyes, or who are looking for a gradual lifting effect rather than an immediate dramatic change, may be good candidates for this combination approach. Because the treatment works partly through gradual collagen stimulation, it may suit patients who want their results to build naturally over time rather than change overnight.
Patients who have previously used filler alone under the eyes without the result they hoped for may also be good candidates for this combination, since it is specifically designed to address skin quality alongside volume rather than volume on its own. Suitability always depends on individual anatomy and skin quality, which is why this is assessed properly during consultation rather than assumed from a general description.
If tired or hollow under-eyes are a concern, a consultation is the appropriate next step before deciding whether a hybrid PLLA and HA treatment, filler alone, or another approach is the right fit. Dr Rami sees patients at Excellence Medical Boutique in Jumeirah, Dubai, where treatment planning begins with a full assessment of the under-eye area, so the resulting plan reflects your specific anatomy and goals.
It is an injectable treatment that combines poly-L-lactic acid, a collagen biostimulator, with hyaluronic acid, a hydrating and volumizing ingredient. The two work together, one providing more immediate volume and the other supporting gradual collagen production.
PLLA works as a bio-stimulator, encouraging the skin’s own tissue to produce collagen gradually over time. Hyaluronic acid works more immediately by adding hydration and volume to the treated area.
This particular combination is commonly used for the under-eye area and for lifting, though suitability for other areas depends on individual assessment. Your practitioner can advise on the most appropriate use for your specific concern.
Filler alone mainly adds volume and is largely effective from the moment it is placed. This hybrid treatment still uses hyaluronic acid for that immediate effect, but pairs it with PLLA to also address the skin’s own structural quality, which volume alone does not fully resolve.
A little bit of swelling in the treated area is a normal part of the process, and many patients notice a lifting effect as the treatment takes hold. Individual healing and results vary depending on your own skin and anatomy.
Patient feedback on this treatment has generally described the injection as more comfortable than expected, though individual pain tolerance varies. This is a good topic to discuss directly with your practitioner beforehand.
Some improvement is visible relatively soon due to the hyaluronic acid component, while the full effect develops gradually as the PLLA component encourages collagen production over the following weeks. A second session is typically scheduled around a month later to assess progress.
Located in the heart of Jumeirah, Dubai, Excellence Medical Boutique is more than a clinic, it’s a destination. A sanctuary where innovation, expertise and care come together to enhance your natural beauty and confidence. Excellence Medical Boutique is conveniently located on 197 Jumeira St, Jumeirah, Jumeirah 1, Dubai. This makes it easy for patients travelling from across Dubai to visit for consultation and treatment.
