Tear Trough Fillers – Reduce Under Eye Hollowing

Posted by Dr Theva in Injectables.

Tear trough filler treatment (or under eye filler as it’s sometimes known) does what creams or makeup never can. Plumps and smooths the under eye area by filling in the hollows that become deeper as we age. 

With an instant rejuvenated and refreshed look post treatment, it’s easy to understand why tear trough fillers have become so popular.  

It’s important to remember that the under eye area is one of the riskier places to inject due to its proximity to the eyes. The treatment should not be taken lightly and should only be performed by an experienced cosmetic physician who specialises in the treatment. 

Tear Through Filler for brighter undereyes


The tear trough area runs from below the lower eyelids to the upper cheek. This is what people might sometimes refer to as the eye socket. 

In many people tear trough hollowing may begin to show at a young age but it’s normally due to the natural process of ageing.

Trough the ageing process, our skin loses laxity. The fat pads on our cheeks separate and start to descend. This gradual loss of support in the mid-cheek pulls down on the lower eyelids, causing tear trough hollowing. The hollowing that occurs also increases the appearance of dark circles and fine lines and wrinkles. 


The deep tear trough indentation under the eyes is frequently mistaken for skin discolouration, but in reality, the dark circles under the eyelids are created by something known as tear trough hollowing.

The hollowing occurs in plenty of patients of various ages and is a result of skin and muscle tissue laxity. For some, it’s caused by lifestyle choices, such as smoking, that leads to skin laxity ageing prematurely. 

For others, it’s caused by the simple ageing process, with the loss of facial volume in this area making the tear trough hollowing deeper and forming dark shadows under the eyes. 

It also has a lot to do with genetics, as some people are much more prone to it than others.


Up until recently, surgery was the only method for correcting the tear trough area, but the introduction of fillers has made it possible for many patients to have it corrected without surgery and with no downtime.

Tear trough filler treatment instantly revies and rejuvenates the under eye area. This is done through non-surgical and non-invasive dermal filler injections. 

Dermal fillers, made up of hyaluronic acid, are the most effective for long-lasting and instant results. The under eye filler treatment can make the tear trough area appear brighter, firmer and plumbed, helping you look and feel more wide awake and youthful. 

Minimising hollowing, dark circles and wrinkles under the eyes will result in a reduced appearance of tiredness, exhaustion and old age, which is a primary concern of many of my patients who enquire about under eye rejuvenation treatments. 


There are 2 different types of approaches for the tear trough dermal filler injections. 

Some practitioners prefer to use a tiny needle for the injection, while others prefer to use a cannula. Using the needle is a standard approach and requires experience and a steady hand. The cannula, on the other hand, acts like a dull straw, allowing the needle to pass through. Some patients prefer it as it has only one entry point on the side of each eye. 

Some practitioners also claim that the cannula allows for more precise placement with a reduced risk of bruising, swelling and vascular complications. 

But what’s more important, when getting under eye filler, is choosing an experienced cosmetic physician who understands the intricate anatomy around your eye.

Unsatisfactory results and complication often occur due to a lack of understanding of the patient’s anatomy and if they’re a suitable candidate for the treatment. 

After both tear trough areas are filled, the area is then massaged well to even out the filler. This is done to produce a more even affect. Patients will be able to see instant results.

The actual treatment normally takes 10 to 15 minutes. For the most part, patients don’t opt-in for a numbing agent for this treatment as there is usually no or very little pain.

But you can absolutely request it. Just know that doing so will mean that you’ll have to wait 30 to 40 minutes for the numbing to set in, extending your appointment a little longer.


Most people find that their tear trough fillers last around 12 months, although they may last as long as 18 months in some people.

Hyaluronic acid is a compound that your body makes naturally, so it’s unlikely to cause bad reactions. But it does degrade over time, meaning that your fillers are temporary. You’ll need repeated treatments to maintain long-term results.


Before commencing treatment, I recommend a no-obligation consultation. I take the time to discuss your concerns, goals and desired results. From there, I am then able to develop a personalised treatment plan that will result in the best outcome for you. 

I also perform a comprehensive assessment of your facial anatomy which will give me a chance to determine what’s causing your dark circles and hollowing. 

Believe it or not but, depending on the cause of your dark circles and hollowing, injecting dermal filler directly into the tear trough may not produce the best results. 

Depending on the cause will determine the best treatment option. It’s not a one size fits all kind of deal.

If your hollowing and dark circles are formed due to mid-cheek volume loss than treating the upper cheek is a better option. A firmer cheek filler is injected into the upper cheek. The filler provides structured support to the under-eye area and reduces the appearance of the tear trough.

It’s important to note that a tear trough filler treatment will not be able to treat eye bags but may however, reduce their appearance. 

Also, if your dark circles are caused by darker pigments in your skin, which may be an inherited trait, then filler won’t help to reduce this; instead, it can heighten it. However, most dark circles are caused by hollowness that can be felt and seen under the eyes, which appears like a dark shadow. 


1. Overfilled Tear Troughs

Overfilling the tear trough can lead to lumps, most noticeable when smiling or when looking at the tear trough from above.

Often I see patients who have had filler poorly placed in the tear trough area, often with a cannula, causing a sausage shaped lump under the eye.

Overfilled tear troughs are not a good look. It’s best to dissolve them first then build up the area again using less product.

2. The ‘Tyndall Effect’

The ‘Tyndall’ effect is seen when the filler is injected too superficially under the skin. If placed too superficially, the filler can give a blue/green discolouration which can be seen clearly in the daylight.

This can also be dissolved. Then after a few weeks, the area needs to be assessed to see when I can be treated again.

3. Swelling

Some patients can experience swelling in the mid-cheek or under the eye after tear trough filler. Dermal filler attracts water, and this can cause intermittent swelling under the eye if the filler is placed too closely under the skin.

Again, the solution here is to dissolve the filler. I see this quite frequently with patients getting filler from different clinics and less inexperienced injectors. 

4. Undesirable Results

Undesirable results from a tear trough filler treatment are due to the inexperience of the cosmetic injector and an ineffective assessment of the client’s individual facial anatomy performed prior to treatment.

There’s a steep learning curve to this area because we are trying to camouflage very subtle fat or volume loss on a dynamic area of your face. It requires extra care and precision.

If you’re interested in tear trough fillers, take the time to find an experienced cosmetic physician. A qualified provider will be trained in the correct injection technique. 

They’ll also know how to choose the best injection site and pick the right filler for your individual needs. This will reduce your risk of undesirable results and complications. 

I’ve been performing tear trough fillers for over a decade and have produced fantastic results for my patient. 

I pride myself on being a patient-focused practitioner. while tailoring treatment plans to my patient’s unique needs and desired results. I want to ensure I enhance their natural features and leave them looking healthy and vibrant not just for today but well into the future. 


Begin by booking your free, no-obligation consultation valued at $250 with me today.

During your free, no-obligation comprehensive consultation, I get to know you and discuss your desired outcomes, your ultimate experience, and your concerns so we get it right the first time. We discuss timelines, expectations, best treatments, and payment plans.

Most importantly, I will explain why they are the best options and go over the results you can expect to feel comfortable and confident you are making the right decision.

For more information on Dr. Theva’s tear trough treatments and happy clients, please click here.