Tear Trough Treatment London. Filler, PRP, Polynucleotides Or Surgery
There are four main tear trough treatments, and each fixes a different problem. Filler replaces lost volume. PRP and polynucleotides improve thin, crepey skin without adding volume. Lower eyelid surgery addresses fat that has pushed forward and significant loose skin. Most disappointing tear trough results come from choosing a treatment for the wrong problem, so the first decision is what is actually causing your shadow.
Key points
Tear trough filler adds volume and works quickly, and leading London clinics charge around £450 to £800 per session, up to £950.
PRP and polynucleotides improve skin quality and thickness under the eye but add no volume, so they cannot fill a structural hollow.
Filler under the eye carries specific risks, including puffiness, a bluish tinge when placed too superficially, migration and, rarely, vascular complications.
Filler can be dissolved with hyaluronidase, a prescription-only medicine that non-medical practitioners cannot legally hold or inject, which is a strong reason to have tear trough filler done by a doctor.
Not sure which tear trough treatment you need? Message a GMC-registered doctor on WhatsApp or email team@thewellnesslondon.com.
First, what is causing your shadow
The tear trough is the groove running from the inner corner of the eye down and out across the upper cheek. Four things make it look darker or deeper, and most people have a combination.
Volume loss, where fat and support under the eye have thinned, creating a genuine hollow that casts a shadow. Tilt your face upward toward a light. If the darkness largely disappears, it is a shadow from volume loss.
Thin, crepey skin, where the skin has thinned enough for vessels beneath to show as a blue or purple tinge. Press gently. If the darkness lightens, skin quality is a large part of it.
Pigmentation, where the skin itself is darker, often brown, and common in deeper skin tones. Stretch the skin gently sideways. If the colour stays, it is pigment.
Fat pad herniation, where the fat cushioning the eye pushes forward, creating a bag with a trough beneath it that is often worse in the morning.
Each points to a different treatment.
The four treatments compared
Tear trough filler
What it does. Hyaluronic acid filler is placed beneath the trough to replace lost volume, and the change is visible immediately.
Who it suits. People whose main problem is a true hollow, with reasonably good skin quality and no significant bags.
The risks. The under-eye is one of the least forgiving places on the face for filler. Hyaluronic acid attracts water, so filler here can cause puffiness. Placed too superficially, it can show as a bluish tinge, known as the Tyndall effect. It can migrate over time, and rarely filler can compress or enter a blood vessel, which is a medical emergency. Filler also tends to make fat pad bags look worse rather than better.
The safety net. Hyaluronic acid filler can be dissolved with hyaluronidase. That is a prescription-only medicine, and non-medical practitioners cannot legally hold or inject it, so a non-doctor who places your tear trough filler cannot lawfully treat its most serious complication.
PRP
What it does. Growth factors concentrated from your own blood are injected to improve skin quality, thickness and the vascular environment under the eye. Because it is made from your own blood, allergic reaction is very unlikely.
Who it suits. People whose main problem is thin, crepey, dull skin with a bluish tinge and fine lines rather than a structural hollow.
What it does not do. It adds no volume, so it cannot fill a hollow, and it does not treat fat pad bags. Results build over a course, usually 3 sessions a few weeks apart, with maintenance.
Polynucleotides
What they do. Purified DNA fragments, usually from salmon, act as bio-stimulators that improve hydration, firmness and the quality of thin skin. They suit the under-eye particularly well because they improve the tissue rather than filling it.
Who they suit. Similar to PRP, and often combined with it, since they act on different parts of the same problem.
The caveat. The evidence base is promising but smaller than for longer-established treatments, and a severe fish or seafood allergy should be discussed before treatment.
Lower eyelid surgery
What it does. Lower blepharoplasty repositions or removes herniated fat and addresses significant loose skin.
Who it suits. People whose main problem is bags from fat pad herniation, or marked laxity. No injectable substitutes for it when that is the problem, and filler used to disguise bags usually makes them look heavier.
Want to know which of the four you actually need? Ask our doctors on WhatsApp.
Combining treatments
Many people have more than one component, and sequencing matters. Improving skin quality first with PRP or polynucleotides often means less filler is needed afterwards, or none at all, because a thicker, healthier canvas casts less of a shadow. Where volume is then needed, a conservative amount placed deep by a doctor tends to look more natural and carries less risk of puffiness.
The pattern to avoid is the reverse. Filler added to compensate for poor skin quality, more added when that does not satisfy, and an under-eye that ends up puffy and heavier than before, which is one of the most common reasons people come to have filler dissolved.
Timing and recovery
The under-eye is where bruising is most likely, because the skin here is the thinnest on the body and richly supplied with small vessels. Bruising after any injection can last a week or more, so allow at least 2 weeks before an important event, and never have a tear trough treatment for the first time within 6 weeks of a wedding or similar occasion.
Filler shows immediately, then settles over around 2 weeks. PRP and polynucleotides build over a course, with change appearing over weeks to months.
What tear trough treatment costs in London
Tear trough filler at leading London clinics costs around £450 to £800 per session, and up to £950 in some practices. Doctor-led under-eye regenerative treatment with PRP or polynucleotides generally runs £400 to £850 per session or course at flagship clinics, and Harley Street practices generally charge £500 to £850 per PRP session against £150 to £400 outside the capital. Lower eyelid surgery is a surgical fee in the thousands.
At the lower end you will find under-eye treatment advertised from around £120 to £300, which usually reflects a different product, a weaker protocol and no medical assessment of what is actually causing the shadow.
Our care is doctor-led and priced below flagship central London rates, with your plan and the figure confirmed after your free suitability review.
Ask what your plan would cost. Message us on WhatsApp.
The suitability review
Every enquiry begins with a free doctor-led suitability review rather than a booking. A GMC-registered doctor assesses the under-eye, identifies which of the four causes are contributing and in what proportion, and gives one of two answers.
Approved for treatment, with what is being treated, what is not, how many sessions and a realistic result. Or not approved, in which case we explain what would serve you better, including a surgical opinion where fat pad bags are the main problem.
We decline a meaningful share of under-eye enquiries. This is the area of the face where the wrong treatment does the most visible harm.
Why people choose The London PRP Clinic by The Wellness
The London PRP Clinic by The Wellness is a doctor-led clinic treating from 10 Portman Square in Marylebone and the Light Centre in Belgravia. Every treatment is performed by GMC-registered doctors, and no clinician treats a patient here until they have completed 100 supervised treatments, which matters more under the eyes than anywhere else on the face.
We offer PRP, polynucleotides and combination protocols, so the recommendation follows your assessment rather than a single product. Across our work we report more than 187 five-star reviews.
Book your free suitability review. Message us on WhatsApp, email team@thewellnesslondon.com, or call +44 20 3951 3429.
Frequently asked questions about tear trough treatment
What is the best tear trough treatment?
It depends on the cause. Filler suits a true hollow with good skin, PRP and polynucleotides suit thin, crepey skin, and lower eyelid surgery suits fat pad bags. Most people have a combination.
Is PRP or filler better for tear troughs?
They do different things. Filler adds volume and works immediately but carries under-eye risks including puffiness and a bluish tinge. PRP improves skin quality and adds no volume.
How much does tear trough filler cost in London?
Around £450 to £800 per session at leading London clinics, up to £950 in some practices. Doctor-led regenerative under-eye treatment generally runs £400 to £850 per session or course.
Can tear trough filler be reversed?
Hyaluronic acid filler can be dissolved with hyaluronidase, a prescription-only medicine that non-medical practitioners cannot legally hold or inject.
Will tear trough treatment bruise?
Often, because the under-eye skin is the thinnest on the body. Bruising can last a week or more, so allow at least 2 weeks before an important event.
Can filler fix under-eye bags?
Usually not. Bags from fat pad herniation tend to look heavier with filler, and lower eyelid surgery is the treatment that addresses them.
This article is for information and does not replace personal medical advice. Individual results vary and no outcome is guaranteed. The evidence base for polynucleotides is still developing. All treatments at The London PRP Clinic by The Wellness are performed by GMC-registered doctors. Reviewed by [GMC-REGISTERED DOCTOR NAME, GMC NUMBER TO CONFIRM], The London PRP Clinic by The Wellness. Last updated September 2026.
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