Injectables
Under-Eye (Tear-Trough) Filler
Real effect on a true hollow — and the highest-complication site on the face for migration, puffiness and the blue Tyndall shadow.
Also called: tear trough filler · undereye filler · dark circle filler
Verdict — mixed
Real in part — the claim outruns what it actually does.
Evidence grade B
At least one good randomised trial, or consistent findings across controlled studies.
Mechanism
Low-G′ hyaluronic acid placed deep, on periosteum, beneath the orbicularis, fills the ligamentous depression at the orbital rim. Placed too superficially it scatters light blue and holds water.
Citations
- Longevity of hyaluronic acid fillers in the tear trough: an MRI studyDermatologic Surgery · 2018
- Tear trough deformity: anatomy and treatment optionsAesthetic Surgery Journal · 2016
The full read
Periorbital skin is the thinnest on the body and the tear trough is unforgiving: superficial placement produces a persistent blue-grey shadow (Tyndall effect), and this region's filler is notoriously long-lived — MRI studies have found product still present years after injection, well past the marketed duration. It also only addresses hollowing. Dark circles from pigmentation or from a prominent orbital fat pad will not improve, and filling a fat-pad problem makes it worse. Hyaluronidase reverses it, which is the saving grace, but dissolving and re-treating this area repeatedly is its own problem. Injector experience matters more here than anywhere else on the face.