Tear Trough Fillers

Non-surgical cosmetic treatment to reduce the appearance of hollow eyes, under eye bags and dark circles.

Rated 5-Star on

Doctify logo
Close up profile of woman with slight dark circles in the tear trough area

What are tear trough (under eye) fillers?

Tear trough fillers are a hyaluronic acid-based injectable used to reduce dark circles, eye bags and a tired looking appearance. With minimal to no downtime, they are an effective treatment to combat tired-looking or aged eyes.

The natural ageing process and various lifestyle aspects can contribute to an aged appearance around the eyes. But, careful administration of fillers under the eyes helps replace lost volume, conceal dark circles and smooth the skin. This results in a more youthful appearance overall. After tear trough fillers, patients feel an increased sense of confidence in their appearance - no longer worrying that they 'look tired all the time'.

Why should I choose tear trough filler?

As we age, our facial anatomy changes. Hollow tear troughs, dark circles, eye bags, and wrinkles around the eyes become more visible. This contributes to an aged/tired appearance. Sometimes we can even look tired when we are not.

Thankfully, we can do something about these common concerns. Tear trough fillers are an excellent treatment for filling hollow tear troughs. They can also conceal eye bags if a hollow tear trough accompanies them. The results can be remarkable, restoring lost volume to the tear trough area and confidence to patients.

Which cosmetic concerns does an under eye filler procedure treat?

Tear trough fillers address several cosmetic concerns:


The under eye can hollow over time because of dehydration, lack of sleep, weight loss and the natural ageing process. Sometimes, under eye hollowness can signify a medical condition.

Dark circles

Dark circles may appear for many reasons. Lifestyle patterns such as alcohol, salt, sun damage, poor sleeping habits and diet can worsen dark circles. Sometimes, genetics are just playing their part. In other instances, external factors like food allergies can contribute to dark circles.

Fine lines and wrinkles

The skin around the eyes is delicate. As we age, skin quality decreases as collagen and elastin break down. Skin sags and fine lines, and wrinkles can appear. Facial expressions, sun exposure and other environmental factors contribute to fine lines and wrinkles and make the appearance worse.

What are the benefits?

Tear trough filler treatment has many benefits:

  • Reduction of dark circles
  • Addition of volume under the eyes
  • Rejuvenation under the eyes - less appearance of ‘tiredness.’
  • Improvement to skin quality under the eyes
  • Reduction of fine lines and wrinkles
  • Non surgical
  • Instant results
  • Minimal to no downtime
  • Improved sense of confidence

How quickly will I see the results from my tear trough treatment?

You will see the results immediately. The procedure takes around 20 minutes. However, the final result will be visible a few weeks after treatment as the fillers need time to integrate with the surrounding tissue.

What are the potential side effects?

All aesthetic treatments have a chance of side effects. If experienced, most post treatment effects last only a few days.

Common side effects of tear trough filler:

  • Soreness or discomfort at the injection site - short-lived and should resolve within 48 hours.
  • Redness at the injection site - short-lived and should resolve within 48 hours.
  • Mild swelling or bruising around the eye - short-lived and should resolve within a few days.

Less common side effects of tear trough filler:

  • Post-procedure infection - treated with the use of antibiotics.

Serious complications of tear trough filler:

  • Scarring
  • Filler migration
  • Vascular occlusion and blindness

It’s important to remember that serious complications are rare. If you experience any serious complications, contact your practitioner immediately for advice. Timely recognition of symptoms is important for early diagnosis and management of severe complications.

Who is the ideal candidate for a tear trough filler treatment?

A suitable candidate for tear trough filler is a patient with hollowing, dark circles or deep lines under the eyes.

Between the lower eyelid and the cheek lies the tear trough. As we age, a hollow groove appears in the area. The eyeball is in a bony socket called the orbit cushioned in orbital fat. Over time, the orbital fat bulges forward, resulting in eye bags which also can make the hollow tear trough appear worse. We call this the ‘tear trough deformity’ and patients experiencing it are suitable for under eye filler.

Tear trough filler can completely transform the under-eye area, giving a more youthful, rejuvenated appearance. But, as with any cosmetic procedure, it's important to book a consultation with a qualified medical practitioner. The under eye area is complex and Miss Hawkes will determine your suitability for the treatment at the initial consultation.

Why should I choose Miss Elizabeth Hawkes?

Miss Elizabeth Hawkes is a consultant ophthalmic and oculoplastic surgeon and a highly experienced cosmetic doctor. She specialises in blepharoplasty surgery, eye surgery and facial aesthetics. Natural enhancement of the face and eye is paramount to Miss Hawkes. She boasts an extensive knowledge of the delicate eye circle area. Furthermore, sunken or hollow under eyes can signify a medical condition. Therefore, the benefits of evaluation from an ophthalmic and oculoplastic surgeon cannot be overstated.

“Elizabeth was professional and knowledgeable, and listened patiently to my concerns regarding Botox and fillers before fully explaining the treatment process. I had full confidence in Elizabeth’s abilities and was absolutely thrilled with the results. I won’t hesitate to book in with Elizabeth again.”

Tear trough filler FAQs

Are tear trough fillers safe?

Many of our patients question if the treatment is safe. This is understandable, as the region beneath the eye is highly delicate. Hyaluronic acid fillers are FDA-approved. When administered by a medical professional like Miss Hawkes, the treatment is a safe and effective way to rejuvenate the tear trough under eye area

Are there any complementary treatments to have alongside tear trough filler?

Miss Hawkes may occasionally recommend patients also have cheek fillers alongside tear trough rejuvenation. Having adequate cheek height and support below and near the junction is important to support the tear trough treatment. We can also combine under eye fillers with other treatments to form a liquid facelift.

At what age should you undergo tear trough fillers?

There is no definitive answer. However, after the age of 30 is usually appropriate. Tear trough fillers are also suitable for younger patients who are experiencing pronounced bags and hollowness under the eyes. Everyone ages at different rates. Therefore, Miss Hawkes will assess the need for a tear trough filler on a per case basis.

Do tear trough fillers hurt?

Many patients wonder if tear trough filler treatments hurt. Tear trough fillers are a minimally invasive treatment. Most patients report that the treatment is pain free. During treatment, Miss Hawkes will apply a topical anaesthetic to the skin to decrease any discomfort. So the treatment may feel a little uncomfortable, but mild discomfort is all that you should expect.

How can I extend the longevity of my treatment?

We recommend the following measures, all contributing to a healthy lifestyle:

Protection from the sun’s UV rays: Using a broad-spectrum sunscreen daily, whether you have fillers or not is one of the best things you can do for your skin. Factor 50 SPF will offer the best protection.

Healthy diet: Steer clear of processed foods and aim to limit the amount of salt and sugar in your meals. Salt is especially best avoided just before and after treatment to mitigate excessive swelling.

Take care of the skin under the eye: Using skincare ingredients that stimulate collagen production such as hyaluronic acid will help extend the longevity of your under eye fillers. Avoid retinol and glycolic acid just before and after treatment.

Minimise stress: Although easier said than done, this can benefit the skin as stress releases high cortisol levels, which can contribute to common signs of ageing.

How long do tear trough fillers last?

Results last 6—18 months, depending on the individual and type of hyaluronic acid used. As with all dermal filler treatments, maintenance is necessary. But, because the tear trough isn’t a very mobile place (unlike your lips or forehead), it takes your body longer to metabolise the filler.

How will the results look?–I’m worried about the overfilled ‘puffy’ look?

When injectors administer filler in excessive quantities, without an understanding of facial anatomy, and not in proportion to the patients’ natural beauty, the results can look ‘puffy’.

Miss Hawkes administers the filler in proportion to the patient’s natural facial proportions, aiming only to replace lost volume. If a patient has natural puffiness of the lower eyelid, she may recommend alternative treatment options. Age-appropriate natural-looking results and a more youthful appearance are paramount to Miss Hawkes. Miss Hawkes prides herself on providing a refreshed appearance, restoring what once was, rather than over-filling any part of the face. As we are aiming to replace lost volume under the eyes, your results will look natural.

You should also refrain from using active ingredients such as retinol and glycolic acid in your skincare routine for the days leading up to your treatment to ensure there's less chance of irritation.

What can cause tear trough fillers to go wrong?

As mentioned, complications with tear trough filler are rare, but can occur. This is usually when an injector uses the wrong type of filler, an incorrect injection technique, or the wrong placement of the dermal filler.

Miss Hawkes administers a dermal filler developed for the under-eye area with a cannula. The use of a cannula reduces the risk of punctured blood vessels or injection into blood vessels, providing a much safer treatment than with a regular needle

What happens during the recovery period?

The entire procedure takes around 20 minutes, and recovery is often quick. The treatment is minimally invasive, with minimal to no downtime, so your regular activities can resume straight away. There is the possibility of bruising and mild swelling. However, swollen patients can use ice packs to manage the swelling. Miss Hawkes recommends that all patients:

  • Do not touch the tear trough area for 3 hours after treatment.
  • Refrain from applying pressure to the tear trough area for the first 6 hours after treatment.
  • Avoid strenuous activity for 48 hours after your tear trough treatment as a precautionary measure.
  • Avoid facials, skin treatments and chemical peels for 2 weeks.
  • Avoid putting on makeup for the first 24 hours after treatment. If makeup is required in your job, we recommend booking a day off as a precautionary measure if possible.
  • Avoid drinking alcohol for 24 hours.
  • Avoid blood thinners for 24 hours.

What happens during the treatment?

Miss Hawkes will go through your medical history and provide a detailed examination of the eyes and face. You can discuss what you wish to achieve from the treatment, and Miss Hawkes will inform you of the risks and benefits.

First, Miss Hawkes will cleanse your under-eye area with an antiseptic, antimicrobial solution to prevent infection. Next, she will apply a topical anaesthetic. She will then inject the filler into the under eye area in small amounts in precise locations using a cannula. Miss Hawkes uses a cannula to help prevent risks of puncturing blood vessels that can cause swelling or bruising. Miss Hawkes will then massage the area to ensure a smooth result.

After the treatment, Miss Hawkes will provide you with a mirror to review the results of your treatment, and will give you aftercare advice

What if I don’t like the results?

The fillers may take a few weeks to integrate into the surrounding tissue. Therefore, please allow for two weeks to see the full treatment results. In the unlikely event that you are unhappy at this stage, please contact Miss Hawkes.

Dermal fillers are dissolvable. Providing you are not allergic, Miss Hawkes can inject a substance called hyaluronidase. Hyaluronidase will dissolve the fillers, returning you to your baseline under-eye within 48 hours.

What is a liquid facelift?

A liquid facelift is a non-surgical technique using hyaluronic acid filler designed to lift and rejuvenate eight areas of the face:

  • Jawline fillers
  • Lower cheek filler
  • Mouth corners
  • Nasolabial folds
  • Pre-jowl folds
  • Tear trough fillers
  • Upper cheek filler

Every procedure is different, and the injected areas will depend on your desired results.

What is hyaluronic acid?

Hyaluronic acid occurs and degrades naturally in our eyes, skin and bodies. It is a gel like substance and a humectant—meaning it can hold over one thousand times its weight in water. Because of this property, it is exceptional at making skin smooth and hydrated.

What is the best treatment for the tear trough region—Botulinum Toxin or dermal filler?

Botulinum Toxin:Botulinum Toxin is a medical and cosmetic neurotoxin. It helps to smooth fine lines and wrinkles.

Dermal fillers: The primary ingredient in dermal filler injections is hyaluronic acid. As it is a gel like substance, it works very well to fill hollow areas under the eye. Therefore, dermal fillers are the best treatment to treat the common concerns of ageing eyes.

We can also use dermal fillers in conjunction with botulinum toxin injections around the eye to help restore the natural beauty of the eye.

Where is the tear trough area?

The tear trough area is the region between the lower eyelid and the cheek.

Who is not a suitable candidate for a tear trough filler treatment?

Anyone pregnant or breast feeding is not a suitable candidate for a tear trough treatment.There have been no large-scale studies regarding the effects of filler while pregnant or breast feeding. Therefore, it is unclear how cosmetic fillers impact unborn babies and nursing infants. More research is needed before knowing the safety. Thus, we discourage having fillers during pregnancy or breastfeeding.

Anyone who has a lidocaine allergy is not a suitable candidate for a tear trough treatment.

Sometimes, an eye surgery (blepharoplasty) might be more suitable for the patient. For example, if the patient has excess skin under the eye. Miss Hawkes will discuss different treatments and options at the initial consultation.

Whom should I see for under eye fillers?

You should seek tear trough filler from a medical doctor or medical cosmetic practitioner only. If injected into the wrong area, or if you have a reaction, it’s vital that you’re in competent hands. An experienced oculoplastic surgeon like Miss Elizabeth Hawkes can provide a safe tear trough treatment with excellent patient care. It's important to remember slight swelling and bruising may occur even in the most experienced hands, but side effects are usually minimal.

Miss Hawkes will ensure that patients are suitable candidates for the treatment and that the dermal fillers are administered with the patient’s natural facial proportions in mind. Medical practitioners have access to hyaluronidase, the substance that dissolves fillers, so when receiving aesthetic treatments from medical practitioners, you can ensure you are in safe hands.

“Dr Hawkes was incredibly professional, but with a very easy and helpful manner. I always felt in very capable hands.”

Dr Hawkes

“As someone who's passionate about restoring the natural beauty of your eyes and face, I've spent over 17 years training to become a blepharoplasty specialist. I've honed my skills in both surgical and non-surgical bespoke treatments, so you can trust me to provide you with the best possible care. Let's work together to help you achieve your desired look and feel more confident in your own skin.”

Miss Elizabeth D Hawkes

Book a consultation

If you would like to book a consultation, please use the form below. We will respond within 2 working days.

British Oculoplastic Surgey SocietyESOPRSAmerican Academy of OphthalmologyImperial College LondonThe Royal College of OphthalmologistsIranian Medical SocietyAestheticsIndependent Doctors FederationCMAC Specialist Advisory BoardPembroke College Circle

© Copyright Harley Street Eyesthetics Ltd.

All Rights Reserved

Privacy PolicyTerms & ConditionsComplaints