Tear Trough

A treatment we approach with caution

Tear-trough filler is one of the most popular and one of the most poorly performed treatments in the UK aesthetics industry. It is the most common reason clients arrive at Aesthetic Clinique for hyaluronidase dissolution, often with chronic under-eye puffiness, blue tints, lumpiness or a face that looks subtly unwell rather than refreshed.

We perform tear-trough filler — but only when we believe the anatomy genuinely suits it, the cause of the under-eye concern is genuinely correctable with filler, and the client has realistic expectations. This means we turn down a meaningful percentage of enquiries, and recommend alternatives in many of those.

Why dark circles are not all the same

Dark circles have multiple causes that look superficially identical and respond very differently to filler:

• Shadow from true hollowing — filler can help
• Pigmentation (often genetic, common in clients with darker skin tones) — filler does nothing; topical or laser treatment is the right approach
• Visible underlying veins or muscle — filler may worsen the appearance via the Tyndall effect, where blue tones show through thin skin
• Fat-pad bulging ("eye bags") — filler makes this worse, not better; surgical assessment is appropriate

We assess all four in consultation and recommend the right tool, which is sometimes not filler at all.

Who tear-trough filler suits

The best candidates are typically clients aged 25–50 with true bony tear-trough hollowing (a visible groove along the orbital rim), reasonably thick lower-eyelid skin, no significant fat-pad herniation, and shadow as the dominant cause of their dark circles. They have realistic expectations of partial improvement, not perfection.

The wrong candidates — clients with prominent eye bags, very thin skin, pigmented circles, or unrealistic expectations — are common, and we will say so.

On the day at Aesthetic Clinique

A tear-trough appointment takes around 40 minutes. We use a blunt cannula in essentially all cases — the under-eye contains critical vasculature and cannula technique substantially reduces vascular risk. Soft, low-cohesivity HA filler is placed deep on the bony orbital rim in very small aliquots. We treat one side, reassess, then treat the other.

Mild swelling and occasional bruising are normal. Settling is slower than other areas — full settling is typically at 3–4 weeks rather than two. We review at two weeks regardless.

Longevity and reversibility

Tear-trough filler often lasts 12–18 months or longer because the area moves very little. If the result is not what you wanted, hyaluronidase fully reverses HA filler in this region. We treat dissolving here with particular care — see our hyaluronidase service for detail.

If we don't think filler is right for you, we will tell you. Sometimes the best answer is cheek filler instead, sometimes a topical pigmentation protocol, sometimes polynucleotides for skin quality, and sometimes no treatment at all.