Tear Trough Filler (Under Eye Filler)

The area beneath our eyes, often referred to as the tear trough, is a delicate and vital part of our facial aesthetics. Many individuals find that with age, fatigue, or due to genetic factors, this area can develop a range of concerns such as dark circles, hollowness, and the emergence of fine lines and wrinkles. These changes can often make a person appear more tired or older than they actually are, impacting their overall appearance.

Tear trough fillers have emerged as a popular solution to these issues. These dermal fillers offer a safe and effective method for enhancing the under-eye region. The primary objective of using these fillers is to introduce additional volume to this area. This added volume plays a crucial role in smoothing out any fine lines and wrinkles that have formed. Moreover, it significantly reduces the appearance of hollowness and dark circles under the eyes, contributing to a more refreshed and youthful look.

RELATED: Why Under Eye Filler is Not For Everyone

The procedure involving tear trough fillers is typically straightforward and is admired for its ability to produce immediate and noticeable improvements. By addressing the root causes of under-eye concerns such as volume loss and skin laxity, these fillers provide a rejuvenating effect. It’s a transformative approach beyond superficial treatments, offering a deeper restoration of the under-eye area’s youthful contours and brightness.

Tear trough filler, or under eye filler, is a commonly performed anti-ageing treatment at Centre for Surgery in London.

The tear trough area is the inner part of the lower eyelid, also known as the nasojugal groove. With ageing, fat gradually decreases in the lower eyelid and adjacent upper cheek region. A loss of collagen and elastin causes the skin and muscles in the lower eyelid to lose their underlying structural support. Eventually, the changes caused by the loosening of the soft tissue attachments cause the tear trough area to become swollen and appear protruding. With prolapse of the underlying tissues, the formation of eye bags occurs. Dark shadows develop, and these can give rise to the appearance of dark circles under the eyes. Despite the use of make-up, the face can still appear tired. Using dermal fillers to rejuvenate the tear trough region is a highly effective treatment for facial rejuvenation in both men and women.

RELATED: Under Eye Fillers – Are Tear Trough Injections Worth It?

Tear trough deformity, also known as under-eye hollows, is a common cosmetic concern characterised by a hollow, sunken appearance under the eyes. It is caused by a loss of volume and thinning of the skin and soft tissues in the under-eye area, resulting in a depression or groove that extends from the inner corner of the eye to the mid-cheek.

RELATED: Sunken Eyes – Causes & Treatments

Tear trough deformity can be genetic or age-related, and it can affect individuals of all ages and skin types. It can make a person look tired, haggard, or older than their actual age, even if they are well-rested and healthy.

While tear trough deformity can be challenging to treat, there are several non-surgical options available, such as tear trough filler injections. The filler is injected into the under-eye area to add volume and fill in the hollows, resulting in a smoother and more youthful appearance.

In addition to filler injections, other non-surgical options for tear trough deformity include chemical peels, laser resurfacing, and microneedling. However, these treatments may not be as effective as filler injections and may require multiple sessions to achieve optimal results.

For severe cases of tear trough deformity, lower blepharoplasty, a surgical procedure to remove excess skin and fat from the lower eyelids, may be necessary to achieve the desired results. It’s essential to consult with an experienced and qualified plastic surgeon to determine the best treatment option for your specific needs and concerns.

Expected Results after Tear Trough Injections

• Reduced appearance of dark circles under the eyes
• Reduced hollow appearance beneath the eyes
• Reduced appearance of eye bags
• A more refreshed and revitalised appearance

Tear trough deformity refers to a sunken, hollow appearance under the eyes that can make a person look tired or older. The following are some of the common causes of tear trough deformity:

Ageing

As we age, the skin and soft tissues around the eyes start to lose elasticity and volume, making the tear trough area appear hollow and sunken.

Genetics

Some people are born with a predisposition to a deep tear trough, which can become more pronounced as they age.

Sun damage

Prolonged exposure to the sun can damage the skin and lead to the development of wrinkles, fine lines, and a hollow tear trough.

Weight loss

Rapid weight loss or fluctuations in weight can cause loss of volume in the face, including the tear trough area.

Poor diet and lifestyle factors

A poor diet, lack of sleep, dehydration, and stress can all contribute to the formation of a tear trough deformity.

Medical conditions

Certain medical conditions, such as allergies, sinus problems, or thyroid issues, can also cause the tear trough area to become more pronounced.

Anatomical factors

Some individuals have an anatomical predisposition to a deep tear trough due to the shape of their skull and facial bones.

Tear trough filler treatments are specifically designed to revitalise the appearance of the under-eye region. This area is particularly prone to showing signs of ageing or fatigue, often manifesting as hollowness, dark circles, and the presence of lines and wrinkles. These aesthetic concerns can significantly affect the overall appearance of one’s face, lending a tired or aged look.

RELATED: How to Get Rid of Eye Bags

The primary approach in these treatments involves the use of specialised fillers. These fillers are meticulously injected into the tear trough, the area just beneath the lower eyelid and above the cheek. Their primary function is to restore lost volume in this region, which is a common consequence of ageing or genetic predisposition. By adding volume, the fillers effectively smooth out the under-eye area, mitigating the appearance of deep hollows and dark circles.

Additionally, these fillers play a crucial role in softening the appearance of fine lines and wrinkles. They provide a subtle lift and firmness to the skin, contributing to a more youthful and refreshed look. The result is a smoother, more even under-eye area that enhances the overall facial aesthetic.

Tear trough fillers have become a popular non-surgical cosmetic treatment for addressing dark circles and bags under the eyes. Some of the key benefits of tear trough fillers include:

Improved Appearance

One of the most significant benefits of tear trough fillers is that they can dramatically improve the appearance of dark circles and bags under the eyes. By filling in the hollows and reducing the shadows, tear trough fillers can create a more refreshed and youthful look.

Non-Surgical

Tear trough fillers are a non-surgical treatment, meaning that they don’t require incisions or general anaesthesia. This means that there is minimal downtime and patients can resume normal activities immediately after treatment.

Quick Procedure

The tear trough filler treatment is typically a quick procedure that can be completed in less than an hour. Most patients are in and out of the clinic within 30 minutes.

Long-Lasting Results

The results of tear trough fillers can last up to 12-18 months. This means that patients can enjoy their refreshed appearance for an extended period without needing additional treatments.

Minimal Side Effects

Tear trough fillers have minimal side effects, which usually include mild swelling or bruising at the injection site. These side effects are temporary and generally resolve within a few days.

Customisable Treatment

Each patient’s tear trough area is unique, and the treatment can be tailored to meet each individual’s specific needs. This means that the practitioner can customize the filler type, amount, and placement to achieve the best possible results for each patient.

RELATED: Why Under Eye Filler is Not For Everyone

The tear trough area is considered challenging to treat because of its complex anatomy and the delicate nature of the skin in this region. Here are some reasons why:

Thin skin

The skin around the eyes is thin and delicate, which makes it more susceptible to bruising, swelling, and other complications associated with filler injections.

Complex anatomy

The tear trough area is complex, with numerous blood vessels and nerves that must be carefully avoided during injections. Additionally, the area is near the eye, so there is little room for error.

Volume loss

The tear trough area often requires a subtle and nuanced approach, as overfilling the area can lead to a puffy, unnatural appearance. The aim is to restore volume to the area while maintaining a natural look.

High risk of complications

The tear trough area is at a high risk of complications such as lumpiness, overcorrection, and filler migration. To minimise these risks, choosing a skilled and experienced injector who understands the unique challenges associated with treating this area is important.

Limited efficacy of other treatments

Sometimes, alternative treatments such as creams or serums may not address tear trough deformity. Tear trough fillers are often the best option for correcting this issue and achieving natural-looking results.

• Patients with moderate degrees of hollowness under the eyes. A lower blepharoplasty or eye bag removal procedure may be more suitable for those with severe hollowing of the lower eye area.
• Patients who would like to reduce the appearance of prominent dark circles beneath the eyes
• Patients who are constantly reminded by family and friends that they look permanently tired or that they are not getting enough sleep
• Patients who do not take any medications that can increase the risk of bleeding, such as aspirin or medicines containing aspirin

Tear trough filler vs lower blepharoplasty

Tear trough filler, despite its great effectiveness for mild to moderate degrees of hollowness, is not ideal for those with more severe degrees of tear trough deformity. In these cases, a surgical lower blepharoplasty or eye bag removal procedure may be more appropriate. Lower blepharoplasty is particularly effective for patients with significant soft tissue laxity of the lower eyelids and/or the lower eyelid muscles. The presence of festoons is also an indication of lower blepharoplasty. Festoons are well-defined pouches of skin that protrude in the cheek area underneath the lower eyelid and are related to the ageing process. The use of tear trough filler in this scenario would be ineffective, which is why we would always recommend seeing a fully qualified plastic surgeon who can perform all under-eye treatments.

Under eye filler before and after:

The key to eye filler treatment is to be conservative and never over-inject. If required, it is always best to be seen two weeks later for a top-up treatment. Our protocol for all filler injections is to see all patients two weeks later for a clinical assessment of treatment effectiveness.

The success of tear trough injections relies on the patient being adequately prepared for the procedure in the weeks beforehand. Before the procedure, you must stop certain products and medications and reduce your intake of foods high in alpha-omega 3.

Two weeks before tear trough injection

Patients should avoid fish, fish oil nuts or seeds or NSAIDS such as ibuprofen, which have been shown to increase the risk of bleeding. Arnica tablets are beneficial for reducing any post-injection bruising. Arnica tablets can be purchased over the counter from most pharmacies. If you are on any prescription medicines which are known to increase the risk of bleeding, then these may need to be stopped before treatment. You must speak with your GP before stopping any medicines and receive instructions on the best time to restart the medication. Patients on drugs that are vital for their health should not stop using their medication under any circumstances. In this instance, having a tear trough filler procedure may not be appropriate. Patients with a history of cold sores must commence a preventive course of acyclovir before treatment. This is to ensure there is no flare-up of herpes virus infection. Your doctor will be able to prescribe this for you before treatment. Finally, reading and understanding the treatment consent form is essential so you are thoroughly familiar with the benefits, risks and complications associated with tear trough filler treatment.

On the day of your tear trough injection procedure

Please make sure to eat a light meal before your tear trough injections. This helps to raise blood sugar and minimise the risk of fainting during treatment. Many people are understandably apprehensive about needle injections, which is amplified by not having eaten or drunk before your treatment.

Please refrain from wearing makeup before dermal filler treatment in the areas planned for treatment. Your practitioner must remove any makeup from the treatment area before your procedure. You can apply a light make-up product for camouflage immediately after the filler treatment.

Please aim to arrive 30 minutes before your allocated appointment to enable the application of local anaesthetic numbing cream to the lower eye area. Local anaesthetic numbing cream needs at least 20-30 minutes to achieve its full effect, so we ask patients to arrive a little earlier than usual.

Before you leave your appointment, we advise booking your next appointment. This ensures you get your favoured timing, as our practitioners often get booked up to three months in advance. We never double-book patients for any injectable facial procedure, including tear-trough fillers.

The area of skin between the upper cheek and lower eyelid is the recessed area known as the tear trough. The tear trough extends laterally and downwards into the cheek region. The ageing process results in tear troughs that become more prominent in depth and width. The colour also changes to a darker shade. The expert placement of very small and targeted dermal filler containing hyaluronic acid in the tear trough area can lead to a smoothening of the tear trough deformity, giving rise to a more rejuvenated and youthful appearance.

Which are the best types of dermal fillers for tear trough correction?

The optimum hyaluronic acid (HA) dermal filler for tear trough correction depends on several factors, including Fitzpatrick skin type, type of tear trough deformity and skin thickness and texture. Many of our dermatologists and plastic surgeons prefer to use Juvederm Volbella, which is based on advanced Vycross technology, and this is responsible for the uniform smoothness of the Volbella product, which facilitates very accurate tear trough filler injections, leading to more natural results compared with other commonly used brands. Compared with Juvederm Ultra, Juvederm Volbella absorbs much less water, allowing for a more effective tear trough correction without the risk of excessive under-eye swelling. We also use Teoxane RHA dermal fillers for the tear trough area.

Sharp needle or blunt cannula for tear trough filler injection?

Blunt cannulas for tear trough correction differ from sharp needles in that the end of the cannula is rounded and blunt to the touch. Blunt cannulas are often preferred for many tear-trough filler treatments as there is a reduced risk of the blunt cannula piercing a blood vessel, leading to a possible risk of inadvertent intravascular injection. Avoiding injuring blood vessels means there is a lower chance of bleeding and bruising and less chance of complications arising from injecting fillers in blood vessels, including the risk of tissue necrosis and, in sporadic cases, blindness. Precision-designed cannulas for tear trough correction allows injectors to reduce the number of times the skin has to be entered, making for a much more comfortable treatment and potentially smoother-looking results.

Benefits of blunt cannula injection technique for tear trough filler

1. Reduced risk of bleeding and bruising
2. Less treatment discomfort due to fewer cannula entry points compared with the sharp needle technique
3. Reduced risk of intravascular injection causing tissue necrosis and even blindness
4. A much quicker recovery thanks to the advanced atraumatic cannula design, making for more gentle injections

Despite the excellent safety profile associated with the blunt cannula tear trough filler technique, the traditional sharp needle method for filler placement is still used when extremely precise injections of smaller amounts of filler are required. In many patients with milder degrees of tear trough deformity, smaller fillers using sharp needles will prevent potential overfilling, which may occur with the blunt cannula method. Other applications for the sharp needle technique include treating acne scars and treating the upper lip to create the Cupid’s bow. The micro-droplet technique is an advanced method of filler placement only performed by highly experienced dermatologists and plastic surgeons for hyper-accurate delivery of under-eye filler and is commonly used at Centre for Surgery for tear trough correction. We recommend a face-to-face consultation with an advanced injector expert to determine the best type of injection technique.

With tear trough treatment at the Centre for Surgery, it is quite normal to have some localised bruising, swelling, and pinpoint bleeding from the needle entry points. If you had numbing cream applied, then this usually takes 2-3 hours to wear off. You can improve the healing process by following all the post-procedure instructions given to you by your doctor.

Top tips for optimum recovery after tear trough fillers

• Use cold packs gently applied against the treated area for approximately 15 minutes on and 15 minutes off. This should ideally be continued for the first 48 hours after treatment.
• Any strenuous exercise should be avoided for 48 hours to reduce bruising and swelling.
• Do not massage or manipulate your face in any way after treatment. Facials or scrubbing of the face should be avoided for one week after treatment to avoid filler migration. Gentle face washing is allowed.
• Light make-up and/or concealer can be applied immediately after your treatment to reduce the appearance of bruising on the skin.
• Do take arnica tablets to accelerate the disappearance of bruising.
• Pineapples and pineapple juice have been shown to reduce swelling, so it is recommended to have pineapples after treatment.
• Avoid overanalysing your face for the first couple of weeks after treatment. It is very typical to have bruising, swelling and a degree of asymmetry often due to swelling. Your surgeon always recommends waiting two weeks before the final results can appear.
• If you have any pain or discomfort in the treated areas, taking paracetamol is recommended to help with the post-injection pain. NSAIDS such as ibuprofen must be avoided as these increase the risk of prolonged bruising due to their action on blood platelets.

How long do dermal fillers for tear trough correction last?

Hyaluronic acid can last up to 18 months when injected into areas such as the nose or cheeks. Dermal filler effects can appear to reduce after a shorter period. In more mobile and dynamic areas of the face, such as the lips, where muscular contraction and movement are frequent, dermal fillers last a much shorter period. Dermal fillers in areas like the tear troughs or nose can last much longer – often over one year, depending on the type of filler used.

Tear trough treatment offers the advantage of providing immediate visible results. However, the journey to achieving your desired final outcome can vary based on individual factors, particularly the initial depth of your tear troughs. Here’s an overview of what you can expect in terms of seeing results:

Initial Improvement

Right after your tear trough treatment, you will notice an immediate improvement in the under-eye area. The added volume from the fillers begins to counteract the hollowness and reduces the appearance of dark circles and wrinkles.

Tailored Treatment Plan

Depending on the depth of your tear troughs, your practitioner at Centre for Surgery might recommend multiple sessions. This is to ensure a gradual and natural-looking augmentation, which is especially important in cases of significantly hollow tear troughs.

Post-Treatment Side Effects

It’s common to experience some side effects, such as bruising and swelling, in the days following the treatment. These are typically mild and temporary.

Full Appreciation of Results

The true results of your tear trough treatment can be fully appreciated once these side effects have dissipated. This usually occurs within a few days post-treatment. During this period, the fillers settle into place, and the treated area begins to reflect the final outcome more accurately.

How Long Do Tear Trough Treatments Last?

Tear trough treatments using dermal fillers are known for their durability, but like all cosmetic procedures, they do not offer permanent results. Understanding the longevity of these treatments is important for planning maintenance and follow-up sessions.

6-12 Months Efficacy

Generally, the effects of tear trough filler treatments last between 6 to 12 months. This duration can vary depending on individual factors such as skin type, lifestyle, and the body’s natural rate of metabolising the filler.

RELATED: How Long Do Tear Trough Fillers Last?

Considering Top-Up Treatments

As the effects of the filler gradually diminish over time, you might consider scheduling ‘top-up’ treatments. These maintenance sessions are designed to replenish the volume in the tear trough area, helping to maintain the rejuvenated and refreshed look achieved after the initial treatment.

Personalised Treatment Plan

We recommend discussing your long-term aesthetic goals during your consultation. This enables us to create a personalised treatment plan that includes recommendations for future maintenance treatments, ensuring that you continue to enjoy the benefits of your tear trough filler.

Common and expected side effects of tear trough injections:

Bruising

Bruising can last up to 2 weeks post-injection but can sometimes be as long as four weeks in patients with an underlying defect in blood clotting. Bruising can be covered with concealer. Injection of the tear troughs may result in more bruising than usual, as this is known to be a highly vascular part of the face.

Swelling

It is not uncommon to have swelling that is not equal on both sides of the face, as different patients may have degrees of pre-existing facial asymmetry and the amount of filler injected. The swelling usually takes up to 2 weeks to resolve. The patient should sleep in a raised position on two pillows to speed the resolution of swelling. All patients should avoid the gym for the first few days to avoid further swelling. Avoid massage of the treated area to avoid further swelling and possible migration of tear trough filler.

Asymmetry

Facial asymmetry is often related to post-treatment swelling. Patients should wait a full two weeks before an assessment on whether asymmetry is persistent and, if so, it is related to differences in volumes injected. Try to avoid over-analysing your face. It is not uncommon to identify new perceived differences in facial asymmetry after dermal filler treatment that were always there to begin with.

Lumps and bumps

Injections of filler will result in a tissue consistency that feels harder than your skin. You must avoid massage of the area to prevent the filler from migrating. Any feeling of lumps and bumps usually resolves in 2 weeks as the swelling subsides.

Subtle Results

A typical 1ml syringe of dermal filler is roughly equivalent to 1/4 of a teaspoon in volume. After the resolution of tissue swelling, it may become apparent that more filler injection is required if your objective is increased volume. Our specialist facial plastic surgeons and dermatologists take great care to avoid overfilling the tear trough with large volumes at the outset. This is a guaranteed recipe for treatment failure. The optimum approach is always to add volume incrementally with time to achieve the optimum result. If you are new to tear trough dermal fillers, it is often the case that the results will last for a shorter period initially. However, with regular maintenance treatment, the results will be for longer as your body begins to generate its natural collagen in the treated areas.

Possible complications of dermal fillers

• Granuloma formation
• Hypersensitivity reaction
• Allergic reaction
• Herpes virus reactivation
• Acne recurrence
• Skin necrosis from filler injection into a blood vessel
• Extremely rarely – blindness from injection into the glabella or frown region
• Infection and abscess formation

If you experience any of the above-listed complications, please contact your surgeon immediately for an urgent assessment.

At Centre for Surgery, we recognise that each individual’s needs are unique, especially when it comes to facial rejuvenation treatments like those for the tear trough area. To address this, we offer a personalised consultation where we develop a bespoke treatment plan tailored specifically to your requirements. An integral part of this process is providing a detailed breakdown of the costs involved, ensuring transparency and allowing you to make an informed decision.

Cost of Dermal Fillers for Tear Trough Treatment

The starting cost for tear trough filler treatment at our clinic is £450 per session. The specific number of sessions required can vary based on the extent of hollowness in your tear trough area. In cases where the tear trough is notably hollow, multiple sessions may be necessary to achieve the desired outcome. This will be thoroughly discussed and planned during your tear trough filler consultation, allowing for a clear understanding of the overall treatment plan and associated costs.

SmoothEye Treatment Pricing

For those considering the SmoothEye laser treatment, the cost begins at £350 for a single session. At Centre for Surgery, we also offer the benefit of discount packages for clients who book multiple SmoothEye treatments. For instance, a package of three sessions is available at a discounted rate of £1100, providing a cost-effective option for ongoing treatment.

Our aim is to ensure that each patient receives a treatment plan that meets their aesthetic goals and aligns with their budget. We believe in a holistic approach, often recommending a combination of treatments like dermal fillers and SmoothEye to achieve optimal results. This collaborative and tailored approach ensures you receive the best possible care and outcome for your investment.

Centre for Surgery is an excellent choice for tear trough fillers for several reasons:

Highly Skilled Practitioners

At Centre for Surgery, you will be treated by experienced and highly trained practitioners who specialise in tear trough fillers. Our practitioners use advanced techniques and top-quality fillers to achieve the best possible results for our patients.

Comprehensive Consultation

Before any treatment is performed, our practitioners will conduct a thorough consultation to understand your individual concerns and expectations. This will allow them to develop a customized treatment plan that is tailored to your specific needs and goals.

Safe and Effective Procedures

We use only the safest and most effective filler products for tear trough treatments. Our practitioners use precise injection techniques to ensure optimal results with minimal downtime.

Exceptional Patient Care

At Centre for Surgery, we prioritise patient comfort and satisfaction. Our practitioners provide compassionate and attentive care to ensure that our patients have a comfortable and positive experience.

Positive Reviews

Centre for Surgery has received many positive reviews from satisfied patients who have had tear trough fillers and other cosmetic treatments. Our patients have praised our practitioners for their expertise, professionalism, and exceptional results.