Tear Trough Fillers

The tear trough area is the space between the lower eyelids and the cheeks. As we age, the loss of subcutaneous fat, collagen and elastin leads to a thinning and hollowing out of this area, resulting in darkening and loose skin.

Tear trough fillers, also known as under eye filler, are an increasingly popular non-surgical treatment where strategically placed hyaluronic acid fillers replace lost volume, thus improving the undereye shadow and loose skin.

The skin beneath the eyes is very delicate and there are important nerves and arteries in that area, so it is imperative that you choose a suitably medically qualified and experienced practitioner to carry out your tear trough fillers.

There are over 60 brands of dermal filler available in the UK. Those commonly used are Restylane Lyft®, Juvéderm Voluma® Belotero® and Teosyal Redensity®. These are all hyaluronic acid-based fillers which will last 6-12+ months.

There are products available which can dissolve hyaluronic acid fillers, so the effects of these fillers are not only temporary, but they can be reversed, if necessary. The products to dissolve fillers are prescription medicines and must be performed by an expert.

Many dermal filler products are available with the addition of 0.3% lidocaine combined with the hyaluronic acid gel in the syringe. This provides instant relief from pain upon injection and removes the need for a separate nerve block or topical anaesthesia.

However, practitioners want you to feel as comfortable as possible, so you may be offered a topical numbing cream or a local anaesthetic, depending on the treatment and preference of the practitioner.

This Glowday Treatment Guide has been edited and medically verified by Andrew Rankin.

Hyaluronic acid-based fillers can be used on all adults.

Tear trough fillers can help address loss of volume, dark circles and crepey skin.

You may not be an ideal candidate if you suffer from:

• Large (herniated) eye bags
• Excessively loose skin (festoons)
• Puffy/swollen eyes

Depending on the area being injected, the type of filler and the pain relief method being used, clients may find this procedure relatively painless to uncomfortable. Treatments around the nose and lips are usually more painful than other areas but most clients find filler treatments bearable.

You must discuss pain management options with your practitioner and let them know if you are finding the procedure too uncomfortable.

The obvious, immediate and most common side effect is slight bleeding after the needle has been inserted into the skin. Other risks include bruising, tenderness, redness and swelling around the injection site. These signs may take 2-3 days to vanish completely.

Occasionally, a ‘bleb’ will occur. This is where the filler has been injected too superficially (close to the surface) and will need to be dissolved.

Rarely, allergic type reactions can occur after a filler treatment. These include prolonged redness, swelling, itching and/or hardness and bumps in the skin. Such signs may appear at some or all injection points. Sometimes, they can last several months or longer, but this is extremely unusual.

Another rare side effect is occlusions. This is where filler is accidentally injected into a blood vessel and creates a blockage. This presents as whitening of the skin, followed by the area turning greyish-purple. If left untreated, this can result in tissue loss in the affected area. There have been reports of this in lip and nose treatments.

One particular type of occlusion is an ocular occlusion. This is where a blood vessel supplying the eye gets blocked, resulting in partial or complete blindness.

If you exhibit ANY symptoms of occlusion, you need to seek the advice of your practitioner and/or visit accident and emergency immediately. You will need to be prescribed emergency treatment medicines, which is why it is important that you have access to a practitioner who is able to prescribe medicine.

As with any skin treatment, injections should be avoided in areas where the skin is swollen or where infections are present - e.g. active acne.

If you have a history of cold sores or fever blisters in the treated area, filler injections may cause an outbreak. In this case, your practitioner may recommend that you take a course of anti-viral medicine before your treatment to help reduce the likelihood.

If you have a known allergy to hyaluronic fillers or any of the ingredients in the filler product, you must inform your practitioner. An alternative treatment will need to be carried out.

Dermal fillers have not been tested on pregnant women. No medically qualified practitioner would carry out a filler treatment on a pregnant woman.​