Non-filler options for correcting tear trough? (Photo)

Question

Hello, What alternatives to filler exist for fixing a tear trough while maintaining a low body fat (less than 10%)? I had thought of implants but they seem to provide a more bony appearance whereas the issue causing my tear troughs was getting very skinny so I believe something that would look more fat-like would be ideal.

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for your thoughtful question.

For individuals with low body fat and noticeable tear troughs, there are indeed alternatives to traditional dermal fillers that can help restore volume while maintaining a natural appearance. If your goal is to avoid fillers and seek something more fat-like in texture, here are several options to consider:

Fat Grafting (Autologous Fat Transfer):
This involves harvesting fat from another area of your body and carefully injecting it into the tear trough area. It provides a soft, natural-looking correction and can be a great option for someone seeking longer-lasting results compared to fillers. It’s especially ideal for patients with low facial fat, though you must have adequate fat stores in other areas for harvesting.

Nanofat or Microfat Injections:
A refined version of fat grafting, nanofat involves emulsifying fat to create a very fine consistency, which can be used for delicate areas like the tear troughs. This not only adds volume but may also improve skin texture and quality due to the regenerative potential of stem cells within the fat.

Tear Trough Implants:
While less commonly used, implants can add structure and support to the under-eye area. However, as you mentioned, they can sometimes result in a more rigid or "bony" appearance, which might not be ideal if your goal is to mimic lost soft tissue volume.

PRP (Platelet-Rich Plasma):
Although not a volumizing treatment, PRP can help improve skin quality and promote collagen production, which may slightly improve the appearance of the tear trough area when used alone or in combination with other treatments.

Skin Tightening Treatments (e.g., radiofrequency, microneedling with RF):
These can improve skin laxity and texture, making the tear troughs less noticeable—especially when sagging or thinning skin is contributing to the hollow appearance.

Ultimately, the most suitable option depends on your facial anatomy, aesthetic goals, and whether you prefer a more conservative or surgical approach.

Randy Lindgren, MD · Answer

For non-filler alternatives to correct tear troughs, there are a few promising options. PRF (Platelet-Rich Fibrin) biofiller is an excellent choice, as it uses your own growth factors to stimulate collagen production and restore volume naturally, giving a softer, more youthful appearance. Another option is fat transfer, where your own fat is used to fill the tear troughs, providing a fat-like, natural result.
Implants, as you mentioned, may create a more bony look, which might not be the ideal solution for someone with low body fat. To ensure you receive the most accurate and personalized treatment, I strongly recommend scheduling an in-person consultation with a board-certified provider who specializes in facial aesthetics. They can assess your unique needs and guide you toward the best non-surgical solution for your tear trough concerns.

Eric M. Joseph, MD · Answer

You're single photo is grainy and difficult to interpret. In general, under eye grooves are corrected with fillers, fat grafting, or fat transposition. Additionally, if you are a male, a healthy body fat percentage would be between 10% to 20%. If you are a woman, a healthy body fat percentage would be between 18% to 28%. I do not believe that less than 10% body fat is healthful for anybody. I hope this helps you. Sincerely, Dr Joseph

Erin Smith, MD · Answer

Thank you for the question. One alternative to filler for addressing volume deficiency of the midface is a fat transfer. While laser and chemical resurfacing will not address the volume deficiency, they can act to tighten the skin of the lower eyelid and cheek. You may benefit from a consultation with a board certified facial plastic surgeon to properly evaluate you and determine the best plan to reach your goals.

Keera Kang, MD · Answer

Hello Exciting981669. Many patients of mine have done their tear troughs with skinboosters instead. (They are injections to boost your collagen production and they also have nice plumping effects when injected on the right layer.) Some examples of skinboosters that I recommend for the TT are : polynucleotides, polydeoxyribonucleotide, hyaluronic acid - the skinbooster kind, PDLLA and so on). Also you can try Accent Prime - which is a unipolar radiofrequency energy based device, that can be used to create plumping effects especially around your eyes. I hope this helped and also always consult a physician when doing skinbooster treatments bc there may be chances of critical side effects. Good luck and you are beautiful just the way you are ! :))

Chris Atkinson, MD · Answer

PRP or PRF might be a good option for you to try if you didn't want to do fillers in the tear trough.

Leonard Grossman, MD · Answer

Why look for something like that? Why not just go with fat grafting? Even the thinnest of individuals have enough fat to fill in the tear trough. One done properly. The results should be extremely natural and permanent. I hope this helps and good luck from Leonard Grossman M.D. NYC organic Plastic Surgery.

Camille Cash, MD · Answer

If you are wanting to improve the hollows under the eyes but do not want filler, you can consider fat grafting.  The small amount of fat can be harvested from the body and spun down.  It can be injected into the hollow areas to give more fullness.  See a board certified plastic surgeon near you to learn more.

Victor Hugo Zuniga, MD · Answer

Dermaheal Dark Circle Solution is a treatment designed to reduce dark circles under the eyes. It typically contains ingredients like peptides, hyaluronic acid, caffeine, vitamin K, and botanical extracts, which work together to improve circulation, reduce pigmentation, hydrate, and strengthen the skin.
It’s usually applied via mesotherapy injections (small amounts of the solution injected into the skin), though some versions may be available as topical creams. For injections, 4-6 sessions are usually needed, spaced about 1-2 weeks apart, with maintenance sessions every few months. Results can be seen after a few sessions, with improvements in circulation and skin appearance.
For topical use, you apply the cream once or twice a day, but it may take longer to see results. Side effects are rare but can include mild swelling or bruising post-injection. Always consult a professional before starting treatment to ensure it's right for you.

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