23 NOV 2020

How does the tear trough treatment work?


A tear trough is the interface between our lower eyelids and upper cheek. It can be seen as a deep crease and dark circle under the eyes and in most cases becomes more prominent with age. The tear trough treatment, also known as tear trough filler, instantly revives and rejuvenates your under eyes, adding volume and decreasing indentations. It is a non-surgical and non-invasive method, using dermal fillers specially designed for the tear trough area.

Dermal fillers are the most effective for long lasting and instant results that minimise hollows, dark circles and fine lines under the eyes, and as a result will reduce the appearance of tiredness, exhaustion and old age. With the tear trough treatment, the under eye can appear to be brighter, firmer and plumped, helping you look and feel more wide awake and youthful.

Tear trough filler

The tear trough treatment is a dermal filler treatment consisting of Hyaluronic Acid (HA), a natural substance already existing in the body that keeps the skin firm and volumized. The filler is a gel like substance and is injected into the skin via a cannula. A cannula is prepared rather than a needle as the likelihood of swelling and bruising post treatment is minimised.

The tip of a cannula is blunt while a needle is sharp and has a higher chance of piercing the blood vessels underneath the skin, resulting in a bruise. A cannula, however, does not pose the same risk due to its blunt tip, length and flexibility, it is far less likely to pierce and pass through the blood vessels. Instead, the cannula pushes past the vessels, causing less damage under the skin and so less chance of bruising or injecting filler into the vessels.

A needle, due to its sharp tip has a higher chance of injecting filler into the blood vessel, leading to vascular occlusion. The risk of this happening is why cannula is used around the eyes, considering how it is a “high risk” area; therefore using a cannula allows safer, smoother, continuous delivery of filler with just one opening on each side of the face. This results in far fewer injections and overall treatment is less painful.

Indeed, it is important that the substance itself is also safe for this “high risk” area. At Dermamina London, we offer only the highest quality, market leading dermal filler for the tear trough area and this is Teosyal Puresense Redensity II, which is made of hyaluronic acid and is the ideal filler designed to restore volume under the eyes.

It is well known to be a lightweight gel and ideal to fill in the delicate skin under the eye, providing support without rigidity, so that emotions and facial expressions are not negatively affected. The filler is also acknowledged to attract very little water unlike other hyaluronic gels, resulting in minimal swelling after injecting and ensures a soft authentic finish and long lasting results.

The beauty of using hyaluronic acid is that it dissolves naturally and gradually over time, with no toxic effects on your body as it is found throughout the body and it has many functions to providing the skin with volume and helping you look younger in appearance.


What causes tear trough?

The frame around the eyes is delicate, which is why it appears hollow and darker in colour than elsewhere on the face. The ageing process plays a large role in the cause of the tear trough hollows, but other factors can contribute, so younger people are affected as well.

The appearance of the tear trough is the result of skin and muscle tissue laxity. It is very common in many individuals of various ages and for some it is caused by lifestyle factors, which causes skin laxity to age prematurely. For many others it is a result of the ageing process and the loss of facial volume and collagen in this area, causing hollowness and thus dark circles under the eyes. During the ageing process, the body loses collagen, which gives the skin its strength and flexibility.

The first area where collagen loss is most visible is the skin under the eyes. The loss causes the eyes to settle back into the eye sockets, making the eyes appear sunken and form shadows. These shadows make the frame around the eyes appear darker and as a result dark circles.

Lifestyle and health factors are also common issues affecting the skin under the eyes. This includes:

  • Not having enough water in the body and the intake of too much caffeinated and pre-packaged drinks that can cause diuretic effects and thus dehydration.

  • Vitamin deficiencies and under nutrition can also lead to unhealthy skin and the formation of hollowness under the eyes.

  • Lack of sleep or poor quality sleep can lead to sunken eyes and dark circles.

  • Allergies are another cause that can lead to tear trough hollows to form. Blocked nasal passages or inflammation in the tiny blood vessels below the eyes can be associated with allergies.

  • Sunken and hollow tear trough can be inherited by a person’s genetics or DNA. Just like the position of the eyes in the sockets, the under eye tear trough can be passed down as well.

  • Sagging and sunken skin under the eyes can be triggered by smoking, which causes the degrading of collagen and skin elasticity.

It is without a doubt that there are many factors that cause tear trough hollows to form. Most people that come to Dermamina London for tear trough treatment have similar concerns, such as looking tired and exhausted because of the sunken shadows and hollowness under the eyes, even with enough sleep and regular applications of costly under eye serums. Many patients are tired of spending money on eye creams promising to fix dark circles and puffy eyes, and relying on concealers and powders everyday.

The tear trough treatment is a non-invasive and non-surgical procedure tailored to individual suitability and needs. Dermal fillers can level things out and diffuse dark circles, instantly revitalising the under eye hollows and lines, by plumping up the area and stretching the skin, making it look brighter, healthier and helping to add youth and colour back onto the face. It can also change the way the light shines off the skin, reducing the appearance of dark circles.

What is the procedure like?

During initial consultation, Mina will go through your medical history and assess your tear trough area; texture and thickness of the skin above the cheek will be checked, in order to determine your suitability before continuing into the details.

There will be a discussion of what you wish to achieve and expect from the treatment, then after Mina will explain the specific benefits of the treatment, risks, complications, post treatment advice and more to allow you to reach an informed decision. Once you get the green card and it is determined that the tear trough treatment will be beneficial for you, the treatment will begin.

The treatment begins right after the consultation, firstly the under eye area gets disinfected to prevent any infections, then numbing cream is applied on both the opening sides, numbing the area to minimize pain and risk of bruising. Next, a cannula is prepared with premium dermal filler, which gets injected slowly and gradually, with only one opening on each side of the under eyelid, reaching all the areas beneath the skin.

By using a cannula and opening only one entry point on each side will reduce the risk of bruising, swelling and vascular complications. We advice avoiding any alcoholic drinks a couple days before the treatment, and taking any blood thinning medications such as aspirin and ibuprofen at least 2-7 days before the treatment. This will be discussed with you prior to the treatment and will be asked in the medical questionnaire.

After both the tear trough areas get filled and massaged well, to even out the filler and diffuse the dark circles and soften the hollowness, patients will be able to see instant results. The area under your eyelids will be revitalised and restored, with no downtime or major swelling or bruising, allowing you to get back to living your life with minimal disruption.

One of the other major benefits of the non-surgical tear trough treatment is that unlike surgical treatments, the patient is awake and can be involved throughout the treatment, seeing and feeling the change unfold. The treatment takes no longer than 10 minutes and most patients feel none to minimal pain

Side effects and complications

The idea of having a treatment done under the eye can cause uncertainty for many, especially as it is a complex area. Therefore, it is important to understand the risks and complications involved, and what fillers are safe to use under the eyes. Most importantly, tear trough treatments should only be undertaken and treated by experienced practitioners.


The dermal filler specially used for the under eye is made of hyaluronic acid, which is a natural substance that already exists in the human body. When inserted into our bodies, the filler increases fullness and decreases indentions under the eye. The benefit of hyaluronic acid is that it can be easily dissolved with a natural enzyme called hyaluronidase (also found in our bodies). This can be used to dissolve fillers for those that do not like the result or want to lessen the amount under the eyes. If severe complications occur, the filler can be dissolved to prevent further risks.

As the under eye area is intricate, it carries the same risk of necrosis as your lips, and this occurs when the injection accidently goes into an artery, causing premature death of cells. Other complication and side effects of the treatment can include headache, allergic reaction, edema (swelling), filler forming into lumps, vascular side effects and in very rare cases blindness due to central retinal artery occlusion. This is very rare in the cosmetic field and so it is important to make sure you are in safe and experienced hands.

Post treatment advice and results

Tear trough filler treatment is long lasting and can last up to 18 months, for some even longer. While results are generally long lasting, it is not a permanent resolution, fillers do break down gradually over time. Lifestyle factors and person’s metabolism can contribute to the fillers breaking down faster. As it is a non-surgical, temporary treatment, patients can maintain the results by repeating the treatment every 1-2 years, to retain their youthful, revitalised appearance.

Following the tear trough treatment, the patient can resume their daily routine, including going back to work on the same day. Results are instant and visible right away, however there may be some slight swelling and bruising for the first couple of days. It is important to follow post treatment advice to minimise bruising and prevent any complications. Indeed, post treatment advice will be provided before and after the treatment, which includes:

No exercise or extreme activities, including lifting heavy items for 24 to 48 hours

Patients should resist touching the injected area for at least six hours following the treatment and avoid showers and washing of the face with hot water. Patients can gently wash the area with warm water after this period, dabbing rather than rubbing the area

No makeup or harsh items on the area for 24 hours. Patients should avoid skincare products for at least the first hours following the treatment

Avoid alcohol consumption for 24 hours

Patients are also advised to avoid traveling and staying out of extreme heat (e.g. steam rooms, saunas, sun beds) for two weeks

Ice pack/compress can be applied to the area every few hours to reduce swelling

Arnica gel can be applied or tablets can be taken to help reduce bruising. It is important to read the label before consuming or applying.

At Dermamina London, we make sure all our patients are aware of the risks and complications included in the tear trough treatment and we emphasise how important it is to follow post treatment advice and when to refer back, especially if severe complications occur. We provide follow up services for patients that want to have the area checked up. A great benefit of using dermal fillers is that it can be easily dissolved with hyaluronidase (an enzyme that naturally exists in our bodies) for those that want to reverse the treatment or want to reduce it slightly for a more subtle look.

Where to get tear trough treatment in London

To learn more about the tear trough procedure and whether or not you are a candidate for the treatment, you can give us a call or send us a message and we will be more than happy to help and schedule a consultation for you. Treatments will only ever be carried out by a highly skilled practioner, in a very safe medical environment. Dermamina offers bespoke treatments in the vibrant city, London. We are located just a two-minute walk from Marble Arch station, and walking distance from Bond Street station and Oxford Street. Contact Dermamina for a consultation to find out if the tear trough filler is right for you today!