Undereye Tear Trough Filler: What You Should Know

Your tear troughs — the region beneath the lower eyelid and above the cheek — can look dark or hollow, and often become more noticeable with age. Under-eye fillers can plump this zone, though they carry certain risks.

A tear trough is a pronounced fold between the lower eyelid and upper cheek. It can cast a shadow beneath the eyes, creating a fatigued look. Many people feel their tear troughs contribute to an aged appearance.

In some cases, tear troughs are inherited. In others, they become more apparent over time as facial tissues lose volume with aging.

The aim of a tear trough filler is to lessen the depth of this groove. A qualified clinician injects a dermal filler into the area, which fills and firms the skin. It is a nonsurgical facial rejuvenation option.

Like other facial fillers, tear trough injections have advantages and drawbacks. It’s essential to understand the procedure and possible complications prior to treatment.

What is a tear trough filler?

A tear trough filler is an injectable used beneath the eyes to restore volume under the lower eyelids.

The most common product used is a hyaluronic acid–based filler, though other formulations exist. Hyaluronic acid is a gel-like molecule naturally present in the body.

When placed into the skin, hyaluronic acid adds volume and smooths depressions.

Are tear trough fillers safe?

Tear trough fillers are generally considered safe and are less invasive than surgical options such as fat grafting or fat repositioning.

The FDA has approved one under-eye filler for treating hollows under the eyes in people 22 and older: Juvederm Volbella. However, approval does not eliminate all risk.

The FDA has not approved all filler brands for this area, so ask what product will be used and seek treatment from a reputable physician rather than unregulated medical spas or nonphysician providers.

Results from tear trough fillers are temporary, typically lasting about one year for most patients. Maintenance injections are required for ongoing effects.

Who’s a good candidate for tear trough filler?

Tear trough filler is intended to reduce the prominence of the trough, which can make the face appear more refreshed.

Many people — particularly those who have researched the procedure and hold realistic expectations — may be suitable candidates. Still, you should discuss your medical history with a physician before any cosmetic treatment.

You may be a good candidate if you:

• have mild to moderate under-eye hollowing
• have healthy, relatively thick skin
• have realistic expectations
• understand the results are temporary
• are in good overall health

You may not be an ideal candidate if you:

• have very thin skin
• have excess skin beneath the eyes
• have very deep tear troughs
• have significant fat pads under the eyes
• have an active skin infection in the area
• have a medical condition that increases complication risk
• have pronounced dark circles

Tear trough filler before and after results

Viewing before-and-after photos of real patients can be useful when deciding whether tear trough filler is appropriate for you.

How much does the procedure cost?

The cost depends on how many syringes are required. Shallow troughs may need a single syringe to treat both sides, whereas deeper hollows might require one syringe per side.

Per the American Society of Plastic Surgeons, the average price for a hyaluronic acid syringe is $684. Accordingly, total expenses typically range from about $684 to $1,500, depending on location and practitioner experience.

Tear trough fillers are considered cosmetic and are not covered by health insurance.

Remember that the results are temporary; many patients return for repeat injections every 1 to 2 years to preserve the effect.

What’s the procedure like?

Before treatment, a trained clinician will evaluate your lower eyelids, checking skin texture and thickness and selecting the most appropriate filler.

The procedure is performed in a medical office. Typical steps include:

1. The clinician cleans the skin to lower infection risk. A topical anesthetic may be applied or ice placed on the eyelids to numb the area and reduce discomfort.
2. They prepare a syringe with filler attached to either a blunt cannula or a needle, based on their technique, then place the product beneath the lower eyelid.
3. As the filler is injected, the needle or cannula is slowly withdrawn and the area is gently massaged to distribute the material. The process is then repeated on the opposite side.

What should I know about aftercare and recovery time?

You can leave once the treatment is finished. Expect some swelling, bruising, and redness, which commonly improve within 48 to 72 hours.

The under-eye area will appear fuller immediately, but it may take 1 to 2 weeks to see the final result. Follow post-procedure guidance, which often includes:

• Avoid strenuous exercise for 24 to 48 hours.
• Apply ice during the first 48 hours.
• Do not sleep face down.
• Gently massage any small lumps with your fingertips as directed.

What are the potential complications of a tear trough procedure?

While tear trough fillers are mostly safe, no cosmetic procedure is risk-free. Rarely, under-eye fillers can cause vision loss if a product blocks an artery that supplies the eye.

If injections are performed improperly, aesthetic issues like lumpiness or migration of filler can occur.

Hyaluronic acid fillers have a relatively low rate of lasting adverse effects. Possible complications include:

• headache
• skin color changes
• allergic reactions
• ongoing pain
• swelling around the eye (edema)
• formation of lumps from the filler
• granuloma (localized swelling or inflammation)
• infection
• vascular complications
• unsatisfactory cosmetic outcome
• rare permanent blindness from central retinal artery occlusion

Some problems may arise up to two weeks after treatment. Contact your doctor if you experience:

• worsening bruising
• increasing redness or swelling
• persistent numbness
• severe pain
• signs of infection
• changes in vision
• red or painful nodules
• delayed allergic reaction to the product

How can I find a board certified medical professional?

If you’re considering tear trough fillers, seek an experienced cosmetic surgeon, plastic surgeon, dermatologist, or other trained medical provider.

A skilled clinician will know proper injection techniques, how to choose optimal placement, and which filler is appropriate, reducing complication risk.

To locate a qualified cosmetic surgeon, use the American Board of Cosmetic Surgery search tool. You can also find board-certified plastic surgeons via the American Society of Plastic Surgeons or search for dermatologists through the American Academy of Dermatology directory.

At your consultation, consider asking:

• Have you received specific training in dermal fillers?
• How long have you been performing tear trough injections?
• What training did you undergo for this procedure?
• Do you have before-and-after examples from prior patients?
• How will you determine if fillers are appropriate for me?
• What should I expect during the procedure and recovery?

Takeaway

If you have noticeable hollows beneath your eyes, tear trough fillers may help soften them. The treatment typically uses hyaluronic acid injected under the lower eyelids to create a fuller appearance.

Because effects fade, repeat treatments every 1 to 2 years are often needed. The procedure is cosmetic and typically not covered by insurance.

Tear trough fillers are generally safe, but may not be suitable if you have very thin skin or certain medical issues. A trained medical professional can assess whether this treatment is appropriate for you.