Mirror Mirror
HomeTreatmentsResourcesAboutCareersContactBook Now0482 094 930
Back to Resources
Dermal Fillers

Tear Trough Filler: Treating Under-Eye Hollows

18 March 20265 min read

Why Do Under-Eyes Hollow?

The under-eye area — clinically called the tear trough — is one of the first places to show signs of ageing and fatigue. Several factors contribute to those dark shadows and hollow grooves:

  • Volume loss — the fat pad beneath the eye thins with age, creating a visible depression
  • Bone resorption — the orbital bone gradually loses density, deepening the hollow
  • Thin skin — under-eye skin is the thinnest on the entire body, making blood vessels more visible (contributing to that "dark circle" appearance)
  • Genetics — some people are predisposed to deeper tear troughs regardless of age
  • Lifestyle factors — poor sleep, dehydration, and allergies can worsen the appearance

The result? You look tired even when you are not. Concealer can mask it temporarily, but it cannot replace lost volume or address the structural cause.

0.5mm
Under-Eye Skin Thickness
9–18
Months Filler Longevity
10 min
Typical Treatment Time

How Tear Trough Filler Works

Tear trough filler uses a very soft, low-viscosity hyaluronic acid product placed carefully into the depression beneath the eye. The filler restores lost volume, lifting the skin away from the underlying dark vasculature and smoothing the transition between the lower eyelid and cheek.

The goal is not to "fill" in the traditional sense — it is to replace what has been lost. A well-treated tear trough looks natural because the filler simply restores the contour that was there before volume loss occurred.

Critical distinction: Not all dark circles are caused by volume loss. If your dark circles are primarily due to pigmentation (melanin deposits in the skin), filler alone will not resolve the issue. A thorough consultation will determine the underlying cause and recommend the appropriate treatment.

Why Experience Matters Here

The tear trough is widely regarded as one of the most technically demanding injection sites in cosmetic medicine. There are several reasons for this:

  • Extremely thin skin — product placed too superficially will be visible (the Tyndall effect)
  • Complex anatomy — the infraorbital artery, angular vein, and infraorbital nerve all run through this area
  • Minimal margin for error — even 0.1ml too much can create puffiness rather than correction
  • Variable anatomy — everyone's tear trough is different; there is no single injection point that works for all

This is why we approach tear trough treatment conservatively at Mirror Mirror Aesthetics. Cameron Holland, RN, assesses each client individually, starts with the minimum effective volume, and schedules a follow-up to add more if needed. The philosophy is simple: underfill and refine, rather than overfill and correct.

Our standard: If, during your consultation, we determine that filler is not the right approach for your under-eye concerns, we will tell you — and recommend an alternative. We would rather give you the right advice than perform a treatment that will not deliver the result you want.

The Treatment Process

1

Assessment

Cause analysis — volume, pigment, or skin quality

2

Numbing

Topical anaesthetic for 20 minutes

3

Injection

Micro-doses via cannula for precision and safety

4

Review

2-week follow-up to assess and refine

Most experienced injectors use a cannula technique for tear trough filler rather than a needle. A cannula enters through a single point (typically near the cheekbone) and glides under the skin to deposit filler precisely where needed. This approach dramatically reduces bruising risk and gives the injector better control over placement.

The entire injection process takes approximately 10 to 15 minutes. The filler is placed in micro-droplets — tiny amounts layered carefully to build a smooth, even correction. You can see results immediately, though mild swelling will be present for the first few days.

How Much Filler Is Used?

The tear trough requires very small volumes — this is a precision treatment, not a volume treatment.

SeverityVolume (Both Eyes)Sessions
Mild hollowing0.3–0.5ml1 session, review at 2 weeks
Moderate hollowing0.5–0.8ml1–2 sessions
Significant volume loss0.8–1ml2 sessions (staged)

The total volume is split between both eyes — so 0.5ml total means approximately 0.25ml per side. Staging the treatment over two sessions (initial placement, then a 2-week top-up) is the safest and most precise approach for this delicate area.

Risks & the Tyndall Effect

Tear trough filler carries specific risks that differ from other filler areas. Understanding these helps you make an informed decision.

The Tyndall Effect

This is the most common complication specific to tear trough filler. It occurs when filler is placed too superficially beneath the thin under-eye skin, creating a bluish or greyish discolouration. It is not dangerous, but it is aesthetically undesirable. The fix: dissolving the filler with hyaluronidase and, if appropriate, retreating at a deeper plane.

Puffiness or Malar Oedema

Overfilling or placing filler in the wrong plane can create persistent puffiness — the opposite of the desired effect. This is why conservative, staged treatment is essential. Some clients are also prone to fluid retention in this area, which can worsen with HA filler (hyaluronic acid attracts water).

Vascular Risks

As with all injectable treatments, there is a rare but serious risk of vascular occlusion — filler inadvertently blocking a blood vessel. In the periorbital area, this can affect vision. An experienced injector mitigates this risk through cannula use, aspiration technique, and thorough anatomical knowledge.

Safety first: The tear trough is not a treatment to choose based on price. The skill of your injector is the single most important factor in achieving a good outcome and avoiding complications. Always choose a qualified, experienced practitioner.

Alternatives — Rejuran & Skin Boosters

Filler is not the only option for under-eye rejuvenation. Depending on your specific concern, one of these alternatives may be more appropriate — or may complement filler treatment.

TreatmentBest ForHow It Works
Rejuran (PDRN/PN)Fine lines, crepey texture, skin qualityPolynucleotides stimulate skin repair and thickening from within
Skin boostersHydration, fine lines, dullnessMicro-injections of HA hydrate and improve skin texture
PRP (Platelet-Rich Plasma)Dark circles from thin skin, general rejuvenationYour own growth factors stimulate collagen and skin renewal
Tear trough fillerHollows, shadows, volume lossHA filler restores volume in the tear trough depression

Combination approach: Many clients achieve the best result by combining treatments. For example, Rejuran to improve skin quality and thickness, followed by a small amount of tear trough filler to address any remaining volume loss. This combination treats both the skin and the structure.

Results & Longevity

Tear trough filler delivers immediate, visible improvement — though the final result takes 2 weeks to settle as swelling resolves.

TimeframeWhat to Expect
ImmediatelyVisible reduction in hollowing and shadows
Days 1–3Mild swelling, possible light bruising
Week 1Swelling settles, early result visible
Week 2Final result — follow-up and potential refinement
9–18 monthsGradual natural breakdown of filler

The under-eye area has very little movement, which means filler tends to last longer here than in more mobile areas like the lips. Many clients find their tear trough filler lasts 12 months or more before a maintenance session is needed.

Cost of Tear Trough Filler in Newcastle

Tear trough filler is a precision treatment that reflects the expertise required and the specialised products used.

TreatmentVolumePrice Range
Mild correction0.3–0.5ml$450–$550
Moderate correction0.5–0.8ml$550–$650
Full correction0.8–1ml$650–$750
Rejuran (alternative/complement)1 session$450–$600

The price includes the initial treatment and a 2-week follow-up assessment. If additional filler is needed at the follow-up, this is quoted separately. We believe in transparent, upfront pricing with no pressure to commit to more than you need.

Aftercare & Recovery

The under-eye area requires gentle aftercare to ensure the best possible result. For the first 48 hours:

  • Do not rub or press the under-eye area
  • Avoid wearing eye makeup for 12 hours
  • Skip contact lenses for 24 hours if possible
  • Avoid intense exercise for 24 hours
  • Sleep elevated on the first night to minimise swelling
  • Apply cold compresses gently if swelling is noticeable
  • Avoid blood thinners (aspirin, ibuprofen, fish oil) for 48 hours post-treatment
  • Stay hydrated — this supports the HA filler's integration

Bruising is more common with tear trough treatment than with other filler areas, simply because the skin is so thin. If it occurs, it typically resolves within 7–10 days. Arnica cream and avoiding blood thinners before treatment can help minimise this risk.

Related reading: For a broader look at skin rejuvenation options, explore our guides to Rejuran therapy, skin boosters, and facial rejuvenation.

Common Questions

Frequently Asked Questions

Typically nine to twelve months, sometimes longer. The under-eye area has relatively little movement, which means filler tends to last well in this region.

Some bruising is possible given the delicate nature of the area. Using a cannula technique reduces this risk significantly. We recommend avoiding blood-thinning medications and alcohol for twenty-four hours beforehand.

If bags (puffiness) are the primary concern rather than hollowing, filler can sometimes accentuate them. This is why a thorough assessment is essential — Millie will only recommend tear trough filler if she's confident it will improve your appearance.

Keep Reading

Related Articles

Your Next Step

Ready to Discuss Your Treatment Options?

Book a complimentary consultation with our registered nurse. We\u2019ll discuss your goals and create a personalised treatment plan — no obligation.