Tear Trough Treatment
Under Eye Filler — Honest Guide
Tear trough is the most technically demanding area in facial filler. Done right, it transforms a tired-looking face. Done wrong, it creates lumps, blue tinges and puffiness that last months. Honest take from a clinician with surgical training.
Read this first. Tear trough filler is one of the few treatments where we regularly say no at consultation. Roughly 1 in 4 patients who come in asking for under eye filler are not good candidates and would get a worse result. Our job is to tell you that honestly — not to take your money.
Duration
30 minutes
Results last
9-18 months
Recovery
3-5 days swelling
What causes under-eye darkness — and which type filler fixes
1. Volume deficit (the “tear trough” hollow)
A genuine groove between the lower eyelid and cheekbone. Light hits the cheek but not the hollow, casting a shadow that looks like a dark circle.
→ Filler is the right treatment
2. Pigmentation (melanin)
Brown discolouration of the skin itself. Common in patients with darker skin tones, or after years of sun exposure or eczema.
→ Obagi Nu-Derm or skincare, not filler
3. Vascular show-through
Thin under-eye skin showing the blue/purple of underlying blood vessels. Common in pale skin or with age as skin thins.
→ Skin boosters or Profhilo to thicken skin, not filler
4. Eye-bag puffiness (fat herniation)
Lower-eyelid fat protruding forward, creating bulge above the tear trough hollow. Filling the hollow can make the puffy bag look worse.
→ Surgical referral (lower blepharoplasty), not filler
Tear trough filler before and after timeline
- 1
Day 0 — immediately after
Volume deficit visibly improved. Some swelling — expect to look slightly puffy. This is NOT your final result.
- 2
Day 3-5 — peak swelling
More swelling than other areas because under-eye skin is so thin. Bruising may appear. Cold compress + sleeping with head elevated helps.
- 3
Week 2 — close to final
Most swelling resolved. Result looking refined. Photo this stage to compare to your “before”.
- 4
Week 4 — review appointment
Free follow-up. We assess together. Sometimes a small top-up of 0.1-0.2ml gives the perfect finish. Often nothing more is needed.
- 5
Month 12-18 — natural breakdown
Filler gradually breaks down. Top-up of 0.3-0.5ml typically sustains the result indefinitely.
Note on before & after photos: Real under-eye filler before/after photos from our clinic will be published once we have full written patient consent. Until then, we will not show stock images or competitor photos.
FAQ
What is tear trough / under eye filler?+
Hyaluronic acid filler placed in the hollow groove between the lower eyelid and the cheek. It softens the dark shadow under the eye that comes from a true volume deficit (not pigmentation or tiredness).
Will under eye filler get rid of dark circles?+
Only sometimes. If your dark circles are caused by a hollow casting a shadow, then yes — filling that hollow lifts the shadow. If your dark circles are caused by pigmentation, thin skin showing the underlying blood vessels, or genuine tiredness, filler will not help and may make the area look worse. Honest assessment at consultation matters more here than for any other treatment.
Who is NOT a good candidate for tear trough filler?+
Patients with genuine eye-bag puffiness (excess fat herniation) — filler can make these look bigger. Patients with very thin or crepey under-eye skin — filler can show through as a blue tinge. Patients whose dark circles are mainly pigmentation. We will tell you honestly at consultation if you are not a candidate.
How long does tear trough filler last?+
Typically 9-18 months. Different from other facial areas because the under-eye area has very little muscle movement, so filler tends to last on the longer end of the range.
What can go wrong?+
Tear trough is the most technically demanding area in facial filler. Risks include: lumps, bluish tinge (Tyndall effect), prolonged swelling that can last weeks, and very rarely, vascular complications. Choosing a practitioner with deep anatomical training is essential — Dr Niru's surgical background and slow, conservative technique reduce these risks substantially.
How much does under eye filler cost?+
From £250 per ml at The Azim Clinic. Most patients need 0.5-1ml total across both sides — so £250-£400 for a first session. Free consultation included.
Is the procedure painful?+
Mild discomfort. Topical numbing cream applied beforehand. The filler itself contains lidocaine. Most patients describe brief pressure rather than pain.
What is the recovery like?+
More swelling than other areas — the under-eye skin is very thin. Mild bruising is common. Expect to look slightly puffy for 3-5 days. Plan around any important events.
Honest tear trough assessment
Free 30-minute consultation. We will tell you honestly whether filler is the right treatment for your under-eye concern — or whether something else (or nothing at all) is the better answer.
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