Is It True That Fillers Are Not for Tear Troughs?

I have very deep tear troughs that are genetic. I recently went to a dermatologist that informed me that fillers would not help my situation. She said fillers are not meant for the tear trough. Should I see a second opinion? Should I see a plastic surgeon instead of a dermatologist?

Doctor Answers 15

Injections could work, but they aren't for everyone...

It’s not unusual for patients with tear trough deformities to request plastic surgical consultation. When this situation arises, hyaluronic acid fillers are very effective for treating this problem. Under these circumstances fillers can minimize tear troughs and ultimately improve peri orbital aesthetics.
It’s extremely important to individualize the treatment of tear troughs. In some patients the lower eyelid skin is extremely thin and for this reason injectable fillers aren’t always indicated. In this situation injections may be accompanied by nodules and bluish discoloration.
It’s important to realize that lower eyelid filler injections can be very effective for treating tear trough deformities but aren’t for everyone with this condition. For this reason it’s important that patients with tear trough deformities be evaluated by a board certified plastic surgeon. This surgeon should be able to formulate an appropriate treatment plan for this problem.


Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Fillers can soften the tear trough

Fillers can be used to soften the tear trough area. The choice of filler is important> I prefer the hyaluronic aced fillers because of their consistency, clear nature, and reversibility. Especially in this area, the skin is very thin, lumps may occur and it is nice to be able to inject a hyaluronidase which can smooth the area in a day or two.

Autologous fat transfer is an excellent filler, however I prefer to perform this procedure in the operating room.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Fillers are GOOD for tear troughs

 In a patient with the right anatomy and good skin, fillers are among the best ways to improve the tear troughs.  They work better and are more predictable than fat injections in my opinion.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Fillers not for tear trough

If the primary cause of your under eye dark circles is skin hyperpigmentation, then you will not be a suitable candidate for tear trough dermal fillers.

Most hollow tear troughs are mainly due to volume loss and suitable for treatment with a dermal filler, so I would suggest you seek an opinion from an oculoplastic surgeon who performs a large volume of tear trough dermal filler treatments. 

Sabrina Shah-Desai, MS, FRCS
London Oculoplastic Surgeon
4.9 out of 5 stars 63 reviews

Tear Trough Injections

Tear trough injections are great and really soften the dark circles associated with this problem. There are several products that are easily instilled in this area. Second Opinion?? Absolutely! 

Kristin J. Tarbet MD, FACS
Bellevue Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Fillers For Tear Troughs

Dear azwildcats:

Dermal fillers can be used to soften up tear troughs.  You would thorough assessment to see if you are ideal candidate that would benefit from fillers in this area.  In Canada, I have Teosyal Redensity II at my disposal which works with great effect to soften up tear troughs.  Best wishes.

Praven Chetty, MD
Kelowna Physician
5.0 out of 5 stars 7 reviews

Not true

This question was posted several years ago. Today, there is a Health Canada approved filler for the tear troughs: Teosyal Redensity II. It is designed for the area to fill out the undereye hollows. I’ve performed the procedure many, many times with great results.

Leila Kasrai, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews

Under Eye Fillers, Tear Trough Filler Injection

Under eye (Tear Tough) are can be improved with inj. filler or Fat grafting. 

Use of blunt Cannula can help to minimize the bruising in this area.

Good knowledge of Anatomy & minimum amount of filler in desired area gives best results.

M. Khawar Nazir, MBBS, MS(Derm)
Pakistan Dermatologist
5.0 out of 5 stars 5 reviews

Fillers for Tear Troughs

I inject a lot of fillers and see a great deal of patients in consultation for facial fillers.  The tear trough area can have excellent results when injected properly.  I prefer Restylane or Belotero for this delicate area under the eyes.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with injecting fillers under the eyes.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Tear Troughs Can Be Injected

It may be worth your while to seek a second opinion.  The tear troughs can be injected with a dermal filler if the client is a good candidate for the procedure.  The area above the orbital rim cannon be injected.  It also would depend on which part of the tear trough has the hallowing.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 18 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.