Under-Eye Filler / Tear Trough Correction
A specialised hyaluronic acid filler injection technique targeting the infraorbital hollow (tear trough) — the depression running from the inner corner of the eye toward the cheek — to reduce under-eye bags, dark circles, and sunken appearance without surgery.
How it works
The tear trough is a ligamentous attachment (orbicularis retaining ligament) where the facial fat compartments separate. Volume loss here creates the classic sunken, hollow, or dark-circle appearance. Ultra-soft HA filler (low G-prime products like Juvederm Volbella or Restylane Eyelight) is placed deep (supraperiosteal) or in the sub-orbicularis plane to restore volume precisely. Cannula technique preferred over needle for safety in this vascular area.
Reported benefits
- Under-eye hollow and tear trough reduction
- Dark circle improvement (structural/volume-related cause)
- Refresh tired appearance without surgery
- Immediate results with no downtime in most cases
- Natural-looking rejuvenation
- Reversible with hyaluronidase enzyme if needed
Regulatory status
Approved for: Periorbital volume restoration, Tear trough correction
Tear trough filler is a recognised aesthetic procedure in EU. Multiple CE-marked HA fillers used for this indication. European aesthetic medical societies have published guidelines on safe cannula technique for this high-risk area.
Approved for: Periorbital volume restoration and rejuvenation
Recognised aesthetic procedure using MHRA-registered HA filler devices. Health and Care Act 2022 requires this procedure to be performed by licensed medical practitioners. Considered higher-risk due to proximity to ocular vasculature.
Approved for: Hyaluronic acid fillers FDA-approved for facial wrinkles (on-label), Periorbital use is off-label for most products (Restylane Eyelight approved 2023)
Restylane Eyelight (Galderma) received FDA approval specifically for infraorbital hollowing in November 2023 — the first HA filler with on-label FDA approval for this indication. Other HA fillers used for tear troughs remain off-label. FDA has warned that periorbital filler carries risk of blindness from inadvertent intravascular injection.
Practical details
Frequency: Every 12–18 months
Results last: Immediate results; swelling peaks at 24–48h; final result at 2 weeks; lasts 12–18 months
Contraindications:
- Prominent under-eye bags (fat herniation) — filler may worsen this; blepharoplasty may be more appropriate
- Very thin skin (HA filler Tyndall effect risk — bluish discolouration)
- Unrealistic expectations about dark circles of pigmentary or vascular origin
- Recent eye surgery
- Blood thinning medications
- Allergy to hyaluronic acid
Always consult a licensed medical professional before undergoing any treatment. This information is educational only and does not constitute medical advice.