Aesthetic

Tear trough filler: the area where technique matters most

Half a millimetre of skin over a fixed ligament: this is the area where too much product, or product placed too shallow, shows immediately and stays visible.

What the hollow under your eye actually is

The groove is not a shadow you can fill wherever you like. A ligament tethers the skin to the bone along the lower orbital rim, and above it sits orbital fat that pushes forward with age. The skin covering all of it is about half a millimetre thick, the thinnest on the body. Everything difficult about this treatment comes from those three facts: a fixed tether, a mobile bulge above it, and no skin thickness to hide product.

The patients we turn away

If you wake with puffy lids that improve through the day, you retain fluid, and hyaluronic acid — which binds water — will make that worse for months. If the problem is herniated fat rather than a hollow, filler blurs the transition but the bag stays; that is a lower blepharoplasty case, from €1,800. Thyroid disease, allergic shadowing and very lax lower lid skin belong in the same category. Declining these is not caution, it is diagnosis.

The Tyndall effect and why placement is everything

Hyaluronic acid placed too superficially under thin skin scatters light and shows as a bluish-grey line — the Tyndall effect — which no concealer hides. Product has to sit deep, directly on the bone, in small volumes: 0.3–0.5 ml per side is usually the entire treatment. Overfilling here does not look youthful, it looks swollen. If it does go wrong, hyaluronidase dissolves it, which is precisely why we use no other material in this area.

How long it lasts and what it costs

Filler lasts longer under the eye than almost anywhere else — twelve to eighteen months is typical, sometimes considerably more, because the area barely moves. A session is from €250 a syringe, and the small volumes used here almost always fit in a single syringe; the exact figure depends on the product and is confirmed at consultation. Expect mild swelling and possible bruising for five to seven days, and do not judge the result before two weeks. We review at day fourteen and add a small amount if needed, rather than filling to the final shape on day one.

Swedish Clinic
Swedish Clinic IstanbulReviewed by our clinical team
Frequently asked questions

Tear trough filler: the area where technique matters most

Usually not. The under-eye tolerates only very small, precise volumes, and fat survival here is unpredictable — lumps are difficult to correct because fat cannot be dissolved. Filler wins on reversibility.

Only the part caused by shadow from the hollow. Pigmentation and blood vessels visible through thin skin remain, and they need different treatment. A clinic promising to erase dark circles with filler is overselling.

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