The tear trough is the hollow that runs from the inner corner of the eye down and out across the top of the cheek. When it deepens, it casts a shadow that reads as tiredness or dark circles no matter how well you have slept. It is also one of the most delicate areas of the face to treat, with thin skin and important anatomy close by — which is why it should only ever be treated by someone with genuine experience. At ELM Aesthetics tear troughs are treated exclusively by Melody Steel, a Nurse Prescriber with over 19 years’ experience and a background in the Plastic and Reconstructive Surgery unit at St James’s Hospital.
What it does
A small amount of a soft, specialist hyaluronic acid filler is placed deep in the tear trough to restore the support that has been lost, lifting the hollow and softening the shadow above it. The result is a smoother transition from lower eyelid to cheek and a less tired appearance.
Who it suits — and who it doesn’t
Tear trough filler works best for a genuine hollow with good skin quality and minimal puffiness. It is not the right treatment for everyone who dislikes their under-eyes: where the problem is pigmentation, loose skin, or prominent fat pads (bags), filler can make things look worse rather than better. Assessing this honestly is the most important part of the consultation, and Melody will tell you plainly if you are not a good candidate.
Often, treating the cheeks first restores enough midface support that the tear trough improves on its own, and less or no filler is needed under the eye.
What happens on the day
After careful assessment, treatment is carried out with a blunt cannula from a single entry point on the cheek, which is both safer and gentler in this area than needle injection. Only a small amount of product is used — under-filling and reviewing is always preferable to over-filling here.
Aftercare, in brief
Swelling under the eyes is common and can take up to a week to settle; bruising is possible. Sleep slightly elevated for the first few nights, avoid rubbing the area, and skip strenuous exercise, alcohol and heat for 48 hours. A review at two weeks is part of the treatment.
Honest limitations
Tear trough filler softens hollows; it does not treat dark pigmentation, remove eye bags, or tighten loose skin. In some people the area can look slightly puffy in the mornings. Results vary from person to person, though filler in this low-movement area often lasts a year or more.
What it costs
Suitability is assessed carefully at consultation. A deposit will be required to secure your appointment.
Your questions answered
Am I a good candidate?
If you have a true hollow with reasonably firm skin and no significant puffiness, probably yes. If your concern is pigmentation, bags or loose skin, filler is not the right treatment, and Melody will say so.
Is it safe?
In experienced hands, using cannula technique and appropriate product, yes. It is an advanced treatment and should only be carried out by an experienced medical practitioner — this is not an area for a beginner.
How long does it last?
Often twelve months or more, because the area moves relatively little.
Will it get rid of my dark circles?
It softens the shadow cast by a hollow. It does not change skin pigmentation — if your darkness is colour rather than shadow, other treatments are more appropriate.
Can it be dissolved if I don’t like it?
Yes. Hyaluronic acid filler can be dissolved with hyaluronidase if needed.