Thank you for your question regarding the use of Juvederm Ultra Plus for tear trough injections. Currently, in the United States, tear trough injections are an off-label, non FDA approved area for dermal fillers (although the consensus is that the recently released Ignore Volbella should have this approval/indication by the end of this year.) First of all, you will want to do some research and find an experienced, highly skilled injector who has extensive knowledge of facial anatomy and safely performs tear trough injections on a regular basis. The skin surrounding the eyes is very thin with many blood vessels and nerves and carries a high risk for bruising and other complications. In our office, we first perform a comprehensive consultation and examination for each patient to determine if she/he is a good candidate for tear trough correction, or would be best treated by surgery, lasers, or other procedures with or without filling. We perform tear trough injections using a blunt-tipped cannula and injecting deeply (right over the bone) and minimally under the muscles as we believe this is safest for the patient and provides the best outcome. We recently have transitioned to Juvederm Volbella as it has less swelling and is thinner and less visible but with its increased crosslinking and provides a very smooth, long-lasting, natural looking outcome. To emphasize this point, we tell our patients its all about a natural, proportional result. Proper Botox and filler should not be seen or felt and loom natural. We are one of the top injection practices in the US and In addition to being proud of our Allergan "Black Diamond" status, (making us one of the top 1% of injection practices in the United States), we are privileged to have 2 Allergan national trainers on our staff with all of our expert injectors having extensive training both internally and nationally. Helping our patients safely and effectively achieve their aesthetic goals is our highest priority and we are very grateful for their trust and loyalty!