Tear Trough Fillers

At A Glance Tear Trough Filler

  • Best Results1-2 sessions
  • Treatment RecoveryImmediate
  • Procedure Time10 minutes
  • Skin SpecialistDermatologist, Nurse Injector
  • Duration of Results12 months+
  • AnaestheticNumbing in the filler
  • Back to WorkImmediately
  • Cost$$

Tear Trough Fillers

Tear trough area is one of the most complex regions to rejuvenate. The undereye area has an intimate connection with the eyelid skin, the medial & central cheek (lid cheek junction) as well as the deeper bony structures of the face. In some cases, hyaluronic acid dermal fillers can rejuvenate this area, decreasing shadows & ‘dark circles’. In the majority of patients, there are several factors contributing to shadows, including familial pigmentation, thin skin, vasculature, troughs as well as skin laxity. Addressing these factors will give optimal outcomes.

FactsFacts on treating tear troughs

  • Some but not all tear troughs are amenable to dermal fillers
  • Treatments are comfortable as my most frequently used fillers have numbing agents
  • Building the mid-cheek coupled with tear trough often gives the most natural results
  • Fillers in this area typically last 12 months or more
  • I use a cannula & not a needle as this is safer & more precise
  • Dermal filler procedures do not have any associated downtime  
  • Improving skin laxity, decreasing pigment & blood vessels in this area will result in a better under-eye area

What is a tear trough?

The trough is defined as the area between the lower eyelid & the cheek. A deep trough can give rise to shadows. This in turn can give the impression of dark circles & ‘looking tired.’ Troughs can be genetic (present since young) and/or worsen with age related volume loss.

Can dermal fillers improve or address deep tear troughs?

Troughs are treated non-surgically with dermal fillers. Hyaluronic acid is the most common dermal filler used in this area.

Fillers work by volume replacement & collagen stimulation. This in turn reduces shadows, shallows the tear trough, and diminishes the look of ‘dark circles.’

How much filler is usually required to treat the tear trough area?

The volume required to treat the trough itself is actually very small; somewhere in the order of 0.1 to 0.3 of a ml. As a guide a teaspoon holds 5 ml. In the majority of cases, filler is required to build the other structures that support the trough. The most common area to support is the ‘lid cheek junction.’

Thus, the actual volume required to properly correct dark circles & tear troughs is between 1 to 2 ml, depending on the anatomy & age-related volume loss of each patient.

Do dermal filler treatments hurt?

No. Treatments are painless. I use an instrument called a cannula. This is a blunt hollow device that delivers the dermal filler to a specific area. This means that I typically use only one injection point.

This procedure is well tolerated by most, however for phobic patients, a premedication can be given (either laughing gas, or a mild sedative).

Davin’s viewpoint on tear troughs

The eye area is probably the number one place to rejuvenate, as eye contact is the very first point of contact. Deep troughs can give the perception of feeling tired. The eye area is extremely complex as there is a relationship between the lower lid, trough, cheek junction (lid cheek junction), the medial cheek as well as the orbital rim.

Anatomy plays an important role in assessing if one is suitable for tear trough injections. I generally approach this area last, as building the supporting structures surrounding the trough takes precedence. My technique is cannula, with a hyaluronic acid- based filler; most commonly with a low concentration of HA. Fillers typically last between 1-3 years in this area.

In most patients, I usually build support prior to addressing this area. In older patients I tighten skin with lasers, Tixel or RF prior to filling. Bespoke treatments give the best results. Above all, under-correct this area as it will take up water over time.

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