How much tear trough filler? (photos)

I had 2 treatments of tear trough fillers (juvederm) and Im severelu unhappy w the results~ i still have the indentations AND under my eyes still seems as dark as before. Could this be because it was done incorrectly ir is some other filler/procedure necessary? I am so disapointed after paying 1,000$

Doctor Answers 14

How much volume for tear troughs depends on the patient

Tear trough injections are often performed poorly by physician with less experience.  It is important to seek out an expert in facial injectables for these treatments for best results and to avoid side effects.  It is difficult to tell what was done without a before picture.  Given the photographs now, more filler is needed in the cheek and under the muscle in the tear trough.  With the amount of darkening present in your tear trough, this may be more apparent after lifting and may need to be treated with chemical peels or laser.


New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

How Much Filler For Tear troughs?

Thank you for posting your photos with your question. I would recommend using a 1 cc syringe of a hyaluronic acid filler like Restylane or Belotero, for the lower eyelid tear troughs. Sometimes it takes a combination of techniques for the most natural and optimal results. I recommend that you have an in person consultation with a Board Certified Plastic Surgeon who is experienced with lower eyelid filler techniques. Best wishes, Dr. Richard Swift

Filler for tear trough

You have mid cheek volume loss and a filler such as Voluma or Restylane would help restore your cheek area which would improve the appearance of your tear troughs.  Please consult a cosmetic dermatologist or plastic surgeon who can assess your face and discuss the appropriate treatment for you.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 21 reviews

Dark circles under the eyes


Thank you for your question.

My filler of choice for the tear troughs is Belotero. Juvederm works but perhaps too much was injected. Discuss with the physician and discuss other treatments for the dark circles as they may need other treatments.

Dr Karamanoukian
#RealSelf100 Member

Tear trough

I don't use Juvederm in the tear trough. My preference is to use Restylane or Belotero. Usually, one syringe will provide adequate fill for most patients. Discuss your concerns with your provider.

Tear trough

Thanks for your query.

I usually use just one syringe to get resolution of the troughs, rarely a second one is required.  Juvederm vs Belotero vs Restylane is always a surgeon's preference.  Many times I use Voluma or Radiesse on the rim to fill the area from below.

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 51 reviews

Tear troughs not filling

First off, Juvederm is not the right product for this area. This causes long lasting edema in some cases requiring removal. This should be a tip off that the experience in this area is not great. Also, expect volume improvement not always dark circle improvemwnt. I use Restylane here with cannulas. It needs to be placed along the orbital rim in many cases. Seek out an experienced physician for this. This is the hardest area to get good results. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Tear trough

crcr0124, consider a "SOOF lift blepharoplasty" as a good surgical alternative to fillers. Search the Internet and seek an opinion if interested from a specialist familiar with this approach. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.8 out of 5 stars 45 reviews

Juvaderm for the tear through

Thanks for the great question.  It is hard to comment on whether or not the injection was done correctly without seeing a before picture.  It appears that I can see some filler in the tear trough nearer to your nose but it doesn't look evenly distributed.  Even though most of deformity is in that area, it is important to treat most of the the under eye area to get the best result.  It also looks like your cheeks can use some definition.  By treating all of these areas it will decrease your lid cheek junction and lift your cheek mass closer to you eye.  This will help with the darkness seen under your eyes.

I think juvaderm is a fine product for that area.  I like to also use Restalyne there because it is easier to spread around.

In addition to fillers I would suggest an uplifting eye serum.  Skin care is a great adjunct to non surgical facial rejuvenation. So I would definitely be sure to be on a consistent regimen.

I would be sure to consult with a Board Certified Plastic Surgeon to ensure that you have the proper analysis and plan of treatment for yourself not only now but who can follow you as you age. While there are many providers that now have started entering the cosmetic arena and many are very good at what they do it is hard to determine when you progress to benefiting from surgery without the proper training.  I think you are a long way from any surgical correction but it is nice to establish a good relationship with a Plastic Surgeon you trust.

I hope this helps :)

John Paul Tutela, MD
Livingston Plastic Surgeon
5.0 out of 5 stars 30 reviews

Filler in tear trough

I usually find that one syringe is enough for most patients. However, some may require more. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.