What can be done to help get rid of tear troughs?

My tear troughs have always been too defined for my liking but now that the skin is darkening more and more in the troughs themselves, it's really bothering me - to the point of obsession - it's time to find a solution. What procedures are out there that can treat the worsening appearance of my tear troughs? I really want to avoid surgery but I know there must be other options. What about fillers? Could something like that work?


F, 35, Massachusetts

Dear sophiad20:

Before we can get rid of "tear troughs" we need to understand what they are. The body does its miraculous job within compartmentalized layers. Under the smooth sheet of the superficial skin, even the layers of fat are segmented into microscopic to nickel sized discrete chambers created and separated by moveable fibrous walls. 

In between the eyelid compartment and the upper medial cheek compartment a valley occurs as gravity and aging disunite these 2 functional areas creating the oblique tear trough. The yellow color of the fat which had masked the bluish underlying muscle and bone has separated and now allows light to reflect back as dark circles. Options to improve this include:

  • fill the trough with fat grafting, or 
    • fillers such as Radiesse (due to its white color) and more typically,
    • hyaluronic acid filler such as Juvederm and Restylane
  • pull the 2 compartments together
    • surgically with a eyelid/midface lift
    • minimally invasively with a suture suspension lift such as the Silhouette InstaLift

You can now understand how the bluish color of the underlying muscle is masked by the yellow fat and your yellow make-up foundation. 

Please consult with a talented, Board Certified Plastic Surgeon who understands the anatomy and can therefore make the best recommendations for you. All the best!


Yes fillers may be a good option for you.  You would need to see a board certified doctor for an exam.  Many patients in my practice have this complaint and we find that fillers are a very good option.  I would love to meet with you in person to discuss this further.

I love a product called VOLBELLA for tear trough deformity. Its a gummy filler that literally fills in the trough. The results are impressive after a procedure that should take no longer than 15 minutes.