Dark circles and hollows under the eyes can make the face look tired, even after a good night’s sleep. When they are caused by volume loss, tear trough filler can soften the hollow and create a smoother transition between the lower eyelid and the cheek. It is one of the most delicate areas to treat, and choosing an experienced injector is essential.

What Is Tear Trough Filler?

The tear trough is the groove that runs from the inner corner of the eye toward the cheek. With age, genetics or weight loss, it can deepen and cast a shadow. Tear trough filler uses a soft, low-hydrophilic hyaluronic acid (HA) gel, placed deep in small amounts, to fill this hollow. Because HA can be dissolved with hyaluronidase, it is the filler of choice for this area. Products designed for this zone are available in ranges such as JUVÉDERM®, RESTYLANE®, BELOTERO®, TEOSYAL® and REVANESSE®.

The Tear Trough Filler Procedure

An assessment of the under-eye area, cheeks and skin quality.
Skin disinfection and, often, a numbing cream.
Injection with a fine needle or, frequently, a cannula, which limits entry points and can reduce bruising.
Small amounts of product placed deep, close to the bone.
Immediate assessment of the result, then a follow-up at two to four weeks.

The procedure usually takes 20 to 30 minutes. In many patients, restoring cheek support first improves the tear trough; see our article on combination treatments.

Results: What to Expect

The hollow looks softer right away, but mild swelling can be present for a few days. The final result appears after about two weeks: a more rested look, with less shadow under the eyes. Results often last around a year, sometimes longer. Filler does not treat pigmentation, fine wrinkles or significant puffiness caused by fat pads.

Cost Factors for Tear Trough Fillers

The cost depends on the province, the clinic, the injector’s experience, the product chosen and the amount needed, often a small amount for both sides. The use of a cannula, the inclusion of a follow-up appointment and possible touch-ups also influence the price. Because this area requires expertise, choosing the lowest price is rarely the best strategy. Ask for a detailed quote during the consultation.

Safety and Recovery

The under-eye area has thin skin and many blood vessels, so the risks of bruising, a bluish tint (Tyndall effect), puffiness and, rarely, vascular complications are real. They are reduced by deep placement, small volumes, a suitable product and an experienced injector. Recovery is generally quick: mild swelling and possible bruising for a few days. Apply cold compresses, sleep with your head elevated and avoid alcohol, heat and intense exercise for 48 hours. See our article on reducing swelling and bruising.

Who Is a Good Candidate for Tear Trough Fillers?

Adults with a hollow or groove under the eyes caused by volume loss.
Good skin quality, without significant laxity.
No major puffiness or fluid retention under the eyes.
Realistic expectations.

Patients with significant eyelid bags or very thin, lax skin may be better served by other treatments, such as surgery. In Canada, who may inject fillers depends on the province and the professional college. Clinics can find all products in our hyaluronic acid fillers category.

References

Cohen, J. L., & Dayan, S. H. (2020). Safety and technique of hyaluronic acid filler injection in the tear trough: A review. Aesthetic Surgery Journal, 40(8), 864–872. https://doi.org/10.1093/asj/sjz352

Healthline Editorial Team. (2022, July 22). Tear trough filler: Under-eye filler procedure, safety, and more. Healthline. https://www.healthline.com/health/undereye-tear-trough-filler

All About Vision. (2023, January 15). What is tear trough filler and how does it work? AllAboutVision. https://www.allaboutvision.com/eye-care/cosmetic/tear-trough-filler/

W Cosmetic Surgery. (2023). Tear trough filler: Before and after. https://wcosmeticsurgery.com/before-and-after/tear-trough-filler/

Common Questions About This Topic

How long does tear trough filler last?

Often around a year, sometimes longer, because the area moves little. Duration depends on the product and the patient.

Does it hurt?

Most patients feel only slight pressure. A numbing cream and products containing lidocaine make the treatment more comfortable.

When will I see results?

Immediately, with the final result visible after about two weeks once the swelling has resolved.

Can I wear makeup afterward?

Yes, after 12 to 24 hours, applied gently with clean tools and without pressing on the area.

What tool is used to inject under-eye filler?

Either a fine needle or a cannula. Many injectors prefer a cannula for this area because it limits entry points and can reduce bruising.

Are under-eye fillers different from lip fillers?

Yes. Under-eye fillers use a soft, low-hydrophilic gel placed deep in small amounts, while lip fillers use a flexible gel designed for a very mobile area.

Is a filler cannula the same as a body piercing cannula?

No. A filler cannula is a sterile, blunt-tipped medical instrument designed to move through tissue without cutting it. A piercing cannula is a hollow needle with a sharp tip used to pierce the skin. They are not interchangeable.

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