Tear trough filler typically lasts between 9 to 18 months, with many people experiencing results for around 12 months on average, though longevity varies significantly between individuals. The under-eye area is relatively static with less movement than areas like the lips, which can help filler last longer than in more mobile regions. However, the tear trough is a delicate area with thin skin and complex anatomy, which affects how filler behaves and how long it lasts. Several factors influence duration including the specific product used, with more robust hyaluronic acid fillers designed for this area lasting longer; the amount of filler injected, with conservative volumes sometimes metabolizing faster; your individual metabolism and how quickly your body breaks down hyaluronic acid; the injection technique and depth, with filler placed at the appropriate level lasting longer; your age, lifestyle and activity level; and how well the filler integrates with your tissue. Some advanced products specifically formulated for the delicate under-eye area can last 12 to 18 months or occasionally longer. The tear trough area has good blood supply which can affect filler breakdown rate. Most practitioners recommend review appointments around 9 to 12 months after treatment to assess whether top-ups are needed. With regular maintenance treatments, some people find they need less frequent top-ups over time as the area retains some structural improvement. It is worth noting that filler can sometimes persist longer in the tear trough than expected, and overfilling can lead to prolonged puffiness, so conservative treatment is always advisable.

Tear trough filler is a specialized dermal filler treatment that addresses the hollows, dark circles and tired appearance in the under-eye area, specifically the groove that extends from the inner corner of the eye diagonally across the lower eyelid toward the cheek. The tear trough is the natural depression between the lower eyelid and the upper cheek that can become more pronounced with age, volume loss, genetics or lifestyle factors, creating a shadowed, tired or aged appearance. The treatment involves carefully injecting small amounts of hyaluronic acid filler into the tear trough area using very fine needles or cannulas to add subtle volume, fill the hollow, reduce the shadowing that creates dark circles, smooth the transition between lower eyelid and cheek, and create a more rested, youthful appearance. Tear trough filler is one of the most technically challenging filler treatments due to the delicate anatomy of the area, thin skin that makes any irregularities visible, proximity to important structures like blood vessels and nerves, high risk of complications if performed incorrectly, and the need for extremely precise technique and conservative product placement. The treatment is not suitable for everyone and works best for people with true volume loss in the tear trough creating a hollow; mild to moderate dark circles caused by shadowing rather than pigmentation; relatively good skin quality without excessive wrinkles or very loose skin; and realistic expectations about subtle improvement. Tear trough filler requires an experienced, skilled injector who understands the complex anatomy and can assess whether you are a good candidate, as poor technique can lead to visible lumps, puffiness, Tyndall effect (bluish discoloration) or more serious complications.

The best fillers for tear trough treatment are specifically formulated hyaluronic acid products designed for delicate areas, with particular characteristics that make them suitable for the complex under-eye region. Ideal tear trough fillers should have a smooth, cohesive gel consistency that integrates well with tissue; low hydrophilic properties to minimize water attraction and swelling; appropriate elasticity and G-prime for the thin under-eye skin; and be specifically indicated or suitable for periorbital use. Commonly used and recommended tear trough fillers include Restylane and related products like Restylane-L or Restylane Defyne, which have good cohesivity and natural integration; Belotero Balance, valued for its smooth integration and low Tyndall effect risk; Teosyal Redensity 2, specifically formulated for the under-eye area with added nutrients; Juvéderm Volbella or Volite, which are soft and smooth but require very experienced injectors; and Teosyal RHA 2, which has good elasticity for dynamic areas. The choice depends on your specific anatomy and concerns, with deeper hollows sometimes requiring slightly more robust products while superficial placement needing very soft formulations; the injector's experience and preference, as different practitioners favor different products; injection technique, with some products better suited to cannula versus needle placement; and your individual tissue characteristics. What should NOT be used includes very firm, volumizing fillers designed for cheeks or jawline, as these are too robust for the delicate tear trough; products with high water-attracting properties that could cause excessive swelling; permanent or semi-permanent fillers, which pose too high a risk in this area; and any filler not specifically approved or commonly used for periorbital treatment. The skill of the injector is more important than the specific product, as even the best filler will cause problems if injected incorrectly. An experienced practitioner will choose the most appropriate product for your individual anatomy and use extremely conservative amounts with precise placement.

Tear trough filler can be safe when performed by highly experienced, qualified practitioners who understand the complex anatomy and potential risks, but it is considered one of the higher-risk filler treatments due to the delicate nature of the under-eye area. When performed correctly by skilled injectors, serious complications are relatively rare, but the thin skin, prominent blood vessels, and proximity to the eye make this area particularly unforgiving of poor technique. Potential risks and complications include common minor issues such as bruising, swelling and tenderness, which are more noticeable in this visible area; temporary puffiness or bags under the eyes, which can sometimes persist; visible lumps, bumps or irregularities showing through the thin skin; and Tyndall effect, a bluish discoloration caused by filler placed too superficially. More serious but less common complications include vascular occlusion, where filler accidentally blocks blood vessels, potentially leading to skin necrosis or, in extremely rare cases, vision problems if it affects vessels supplying the eye; migration of filler causing unintended appearance changes; prolonged swelling or persistent puffiness that can last months; and lymphatic obstruction causing chronic fluid buildup. Safety depends heavily on thorough assessment to determine if you are a suitable candidate, with some people being poor candidates due to very thin skin, prominent eye bags, or certain anatomical features; choosing a highly experienced injector who specializes in this area and has extensive tear trough experience; using appropriate hyaluronic acid fillers specifically suitable for the under-eye area; employing conservative technique with small amounts and precise placement; and understanding and accepting the risks before proceeding. Red flags to avoid include practitioners with limited experience in tear trough treatment; anyone who dismisses the risks or suggests this is a simple treatment; use of inappropriate filler products; aggressive volumizing rather than conservative correction; and lack of emergency protocols for managing complications. Tear trough filler is not a treatment to choose casually or based primarily on cost. The potential for visible, difficult-to-correct complications means choosing the most experienced, skilled practitioner possible is paramount, even if more expensive.

Tear trough fillers typically last 9 to 18 months, with most people experiencing results for approximately 12 months, though individual variation is significant. The duration depends on multiple factors including the specific hyaluronic acid product used, with different formulations having varying longevity profiles; the amount injected, though in the tear trough, less is often more and conservative volumes may metabolize at different rates; your individual metabolism, with some people breaking down hyaluronic acid faster than others; the injection depth and technique, with properly placed filler at the appropriate level lasting optimally; your age, as younger people with good tissue quality may retain filler differently than older patients; and lifestyle factors including exercise intensity, stress and overall health. The tear trough area has relatively good blood supply and is subject to constant eye movement and facial expressions, which affects filler longevity. Some people find tear trough filler lasts longer than filler in more mobile areas like lips (6-9 months) but similarly to or slightly less than filler in cheeks or other midface areas. An important consideration is that tear trough filler can sometimes overstay its welcome, with some people experiencing persistent puffiness or visible filler beyond the desired duration. This is why conservative initial treatment is crucial. Most practitioners recommend follow-up assessment around 9 to 12 months to determine if top-up is needed, though many advise waiting until filler has completely resolved before adding more to avoid cumulative overfilling. The goal is subtle, natural improvement that lasts long enough to be worthwhile but not so permanent that it causes long-term issues. If you find your tear trough filler is lasting too long or causing unwanted effects, it can be dissolved with hyaluronidase.

Tear trough filler addresses volume loss and hollowing in the under-eye area, specifically targeting the groove that runs from the inner corner of the eye toward the cheek. The treatment works by strategically placing small amounts of hyaluronic acid filler to fill the hollow or depression, reducing the shadow that makes under-eye circles appear dark; smooth the transition between the lower eyelid and cheek for a more continuous contour; add subtle volume to sunken areas that create a tired appearance; improve the appearance of dark circles caused by shadowing rather than pigmentation; create a more rested, refreshed and youthful look; and enhance overall facial harmony by better connecting the eye area to the midface. It is crucial to understand what tear trough filler cannot do: it does not address true pigmentation or discoloration unrelated to shadowing; it cannot fix significant skin laxity, wrinkles or crepey skin under the eyes; it will not eliminate eye bags caused by fat herniation or loose skin; it cannot address fluid retention or lifestyle-related puffiness; and it does not replace the need for proper sleep, hydration and skincare. Tear trough filler works best for people with volume loss creating a hollow that casts a shadow; mild to moderate under-eye concerns without severe skin laxity; relatively good skin quality; and shadowing-related darkness rather than true pigmentation. The results should be subtle and natural, with the goal being to look more rested and refreshed rather than obviously 'filled.' When performed correctly, people should not be able to identify that you have had filler; they should simply notice you look less tired. Overfilling or inappropriate use can actually make under-eye concerns worse by creating puffiness, visible lumps or an unnatural appearance. The treatment requires extremely precise, conservative technique to achieve the delicate balance of improving hollowing without creating new problems.

Tear trough filler causes varying levels of discomfort, with most people finding it moderately uncomfortable but tolerable, though the under-eye area is quite sensitive. The pain level depends on several factors including the injection method used (needle versus cannula), individual pain tolerance, the skill and gentleness of the injector, and the specific numbing used. Most people describe the sensation as pressure, stinging or pinching, brief sharp sensations with needle entry, or dull aching or pressure with cannula technique. Many practitioners use measures to minimize discomfort including topical numbing cream applied 20 to 30 minutes before treatment; nerve blocks that numb the under-eye area more thoroughly, though this involves additional injections; ice or cooling devices before and between injections; and using pre-mixed filler with lidocaine for additional numbing. The cannula technique, where a small entry point is made and a blunt-tipped cannula threaded under the skin, often causes less pain than multiple needle sticks, though the initial entry and threading sensation can be uncomfortable. Most people rate tear trough filler discomfort as 4 to 7 out of 10 with proper numbing, finding it more uncomfortable than some other filler areas but quite tolerable. The proximity to the eye can be psychologically uncomfortable even if physical pain is minimal. After treatment, the area typically feels tender, tight or bruised for several days; may throb or ache mildly; feels sensitive to touch; and improves steadily over the first week. Most people manage post-treatment discomfort with ice packs, arnica for bruising, sleeping slightly elevated, and avoiding touching or pressing the area. If you are particularly anxious about pain, discuss this with your practitioner beforehand so they can use maximum numbing and employ the gentlest technique possible. The discomfort is temporary and most people find it worthwhile for the improvement in their under-eye appearance.

Before tear trough filler treatment, people typically have pronounced hollows or depressions under the eyes creating a tired, aged appearance; dark circles caused by shadowing in the tear trough rather than true pigmentation; a visible demarcation or step between the lower eyelid and cheek; sunken under-eyes that make them look exhausted even when well-rested; shadows that are particularly noticeable in certain lighting or photographs; or overall facial appearance that seems aged or drawn due to volume loss in the midface. These concerns often worsen with age, weight loss, genetic factors or lifestyle stress. After tear trough filler treatment, once swelling has subsided typically within 1 to 2 weeks, most appropriate candidates experience subtle but meaningful improvements. The under-eye hollows are filled and smoothed; dark circles appear reduced as shadowing decreases; the transition between lower lid and cheek is smoother and more continuous; the face looks more rested, refreshed and youthful; eyes appear brighter and more open; and overall facial appearance is more balanced and harmonious. The degree of improvement varies considerably depending on the severity of original hollowing, with mild to moderate cases showing better results than severe volume loss; skin quality, with good skin elasticity producing better outcomes than very thin, crepey skin; whether darkness is due to shadowing versus pigmentation, as filler only addresses the former; the amount and placement of filler used; the skill of the injector; and realistic expectations about subtle refinement. When performed correctly by experienced injectors, tear trough filler provides natural-looking improvement where people notice you look more rested without being able to identify what changed. However, it is crucial to understand that poor results are also possible, including overfilled appearance with puffiness or bags; visible lumps or irregularities; Tyndall effect causing bluish discoloration; asymmetry; or even worsened appearance. During the settling period after treatment, immediate swelling can make under-eyes appear temporarily puffy or overfilled; bruising is common and can take 1 to 2 weeks to resolve; final results are best assessed 2 to 4 weeks after treatment once all swelling has settled; and the improvement should appear subtle and natural, not obviously 'done.' Your practitioner should provide realistic before and after photos from their own work, showing results after complete healing on patients with similar concerns and anatomy. Be wary of overly dramatic before and afters that show extreme transformation, as this often indicates overfilling that may cause problems. The best tear trough filler results are those where improvement is noticeable but subtle, maintaining natural proportions and avoiding the puffy, overfilled appearance that can occur with excessive treatment. Most people with appropriate expectations and experienced injectors are satisfied with the subtle but meaningful improvement in their under-eye appearance, finding they look more rested and youthful. However, this is a treatment where conservatism, patience and accepting subtle results are essential for satisfaction and safety.