Tear Trough Filler: Expert Under-Eye Treatment

Tear trough treatment addresses under-eye hollowing that creates tired appearance. This delicate area requires particular expertise and careful patient selection for optimal results.

Understanding Tear Trough Anatomy

The tear trough deformity results from multiple factors: volume loss in the deep medial cheek fat, orbital fat herniation, and bone resorption along the inferior orbital rim. This creates a depression extending from the inner corner of the eye toward the mid-cheek.

Age-related changes worsen this hollow. The orbicularis retaining ligament becomes more prominent, creating a distinct groove. Skin thins and loses elasticity. These combined changes create shadows that make eyes appear tired or aged.

Ideal Candidates

Who Benefits Most

Patients with true volume deficiency creating a hollow groove benefit most from tear trough filler. Good skin quality with minimal laxity is important. The tear trough should be the primary concern, not secondary to other issues.

Younger patients with genetic hollowing often achieve excellent results. Older patients with good skin quality and minimal eye bags can also benefit significantly.

Who Should Avoid Treatment

Patients with prominent eye bags won't improve with filler - the bags may appear more pronounced. Those with significant skin laxity need surgical intervention. Chronic fluid retention or malar mounds increase complication risk.

Very thin, translucent skin may show filler visibility or irregularities. Dark circles from pigmentation rather than shadowing require different treatments like chemical peels or laser therapy.

Advanced Injection Techniques

The Deep Injection Plane

Successful tear trough treatment requires deep placement on the periosteum, beneath the orbicularis oculi muscle. This positioning minimises visibility, reduces swelling risk, and provides structural support.

Cannula Advantages

Most experts prefer cannulas for tear trough treatment. The blunt tip navigates safely around vessels, reducing bruising and vascular compromise risk. Single entry points minimise trauma while allowing complete treatment.

Conservative Volumes

Less is more in the tear trough. Typically, 0.2-0.4ml per side suffices. Overfilling creates unnatural fullness or worsens eye bags. Conservative treatment with potential touch-ups yields better results than initial overcorrection.

Product Selection Matters

Tear trough fillers should be soft and have low water-binding capacity. Products that attract excessive water cause persistent puffiness. Some newer fillers are specifically designed for periorbital use with optimised rheological properties.

Hyaluronic acid remains the gold standard due to reversibility with hyaluronidase. This safety factor is particularly important in this high-risk area where complications can be vision-threatening.

Managing Complications

Common Issues

Swelling is expected and typically resolves within 1-2 weeks. Some patients experience prolonged swelling, particularly if prone to fluid retention. Sleeping elevated and limiting salt intake helps.

Blue discoloration (Tyndall effect) occurs with superficial placement. This requires dissolution and possible re-treatment at proper depth.

Serious Complications

Vascular occlusion, while rare, can affect the angular or ophthalmic arteries. Immediate recognition and treatment with hyaluronidase is crucial. Practitioners must understand vascular anatomy and have emergency protocols.

Results and Longevity

Tear trough filler often lasts longer than other areas - typically 12-18 months or more. Limited muscle movement reduces product degradation. Some patients report results persisting over two years.

Results should appear natural - refreshed rather than transformed. The goal is shadow reduction creating a more rested appearance, not complete hollow elimination.

Choosing Your Practitioner

Tear trough treatment demands expertise. Seek practitioners with specific training in periorbital injections. They should discuss risks thoroughly and have clear complication management protocols.

Ask to see before/after photos specifically of tear trough treatments. Results should look natural without puffiness or irregularities. Be wary of dramatic transformations that may indicate overfilling.

Considering tear trough filler? Book your free WhatsApp consultation. Send photos for assessment of whether you're an ideal candidate for under-eye rejuvenation.

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