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, 36, Massachusetts

Tags:woman age 35-44 around the eyes tear trough tear troughs juvederm

Tear troughs can have several causes and will require an examination by an expert to determine what procedure would give the best and most long lasting results.

That being said you can generally get the results you're looking for through dermal fillers like Restylane or Juvederm. Depending on your age, tear trough fillers could be a viable option. You'll see the results quickly and, in the hands of a trained professional, they can last up to a year.

I'd recommend that you avoid plastic surgery your first time out. Although the results from fillers are temporary (again, averaging less than a year), they'll provide you with your first, best option. Tear trough injections are fairly common, but you want to make sure you see someone who is well-qualified in this field -- not just somebody who does it as a one-off procedure -- and that your issue isn’t caused by an underlying medical condition.

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!


Many people come to us to help them with cosmetic, eye-related issues in the tear trough area. There is a lot of information online about corrective measures you can take -- from eye creams to surgery to fillers to correct problems with under eye dark circles, eye bags, upper eyelid and lower eyelid problems, etc.

It already sounds like you're doing your homework on the best methods of tear trough treatment and have uncovered some of the options. Now you need to find a board-certified plastic surgeon or a medical professional that is well-trained and experienced in these types of cosmetic procedures.

It's likely that after you’ve consulted with a few professionals in this field they will initially steer you away from surgical procedures and toward dermal fillers. Dermal fillers can be used in several spots on the face, including tear troughs. Fillers such as Restylane and Juvederm are both hyaluronic acid fillers that can do the job. We prefer Restylane, but check with your chosen surgeon's office to determine what filler they prefer or have the most success with.

Filler injections typically last six months to a year, at which point -- if you like the results -- you'll have to return for another round of injections. At your age (mid-30's) use of fillers is certainly a solid option.

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.