Tear Trough Filler London

The tear trough is a groove running from the inner corner of the eye down and outwards along the orbital rim. It becomes visible for three separate reasons, and they are treated differently. First, the deep fat pads that once cushioned the rim reduce and descend, so light no longer bounces off a continuous surface and a shadow appears. Second, the bone itself remodels — the orbital aperture widens with age, which deepens the hollow independently of fat. Third, the skin of the lower lid is the thinnest on the body, so the darker orbicularis muscle and underlying vessels show through as a bluish or purple tint that reads as a "dark circle" even when there is no hollow at all.

This is why two patients with identical complaints need opposite plans. A genuine volume deficit responds beautifully to a small amount of hyaluronic acid placed deep against the bone. Pigment-led darkness — common in South Asian, Middle Eastern and Mediterranean skin — does not; adding filler there produces weight and puffiness without brightening anything. A careful assessment separates shadow from pigment before a needle is discussed.

The under-eye is treated conservatively and deep. Numbing cream is applied, the rim is marked, and a soft, low-hydrophilic hyaluronic acid is placed in small deposits directly onto the bone beneath the muscle, rather than in the superficial skin where it would be visible as a ridge or attract fluid. Volumes are deliberately small — often a fraction of a syringe per side — because the lower lid tolerates very little product before it looks treated. Where the anatomy allows, a blunt cannula is used to reduce bruising and to keep away from the vessels crossing the orbital rim.

We would rather under-correct and review you in two to four weeks than fill an under-eye in one sitting. Staged treatment is not caution for its own sake; it is how a result stays invisible.

Tear trough filler is one of the treatments we decline most often. Patients who wake with fluid-filled lower lids, who have significant lower-lid laxity, prominent herniated fat pads or malar festoons, will usually look heavier after filler rather than refreshed. Thyroid conditions, salt- and alcohol-related fluid retention and poor lymphatic drainage all push the result in the same unwanted direction. In those cases the honest options are polynucleotide treatment for skin quality, surgical assessment for genuine fat herniation, or simply doing nothing.

If you have already had under-eye filler elsewhere that looks swollen, lumpy or bluish, it can be dissolved with hyaluronidase and reassessed from a clean baseline. That conversation is part of the consultation, not an upsell.

Most patients return to work the same day. Expect mild swelling for three to five days and, occasionally, a small bruise at an entry point that fades within a week to ten days. Sleeping slightly elevated, keeping salt and alcohol low for a couple of days and avoiding strenuous exercise for 24 hours all shorten that window. The result should be judged at two to four weeks, once the product has settled and any fluid has resolved.

Under-eye filler placed deep and in small volumes typically lasts twelve to eighteen months, and often appears to last longer than the product itself because restored light reflection persists as the gel gradually integrates. Maintenance is usually a top-up rather than a repeat of the original treatment.

Our aesthetics is invisible art — quiet, not loud. For under-eyes in particular, the aim is that nobody can identify what was done, only that you look rested. See the tear trough before and after results, or read about what can go wrong with under-eye filler and how it is corrected.