Written by Dr Sabika Karim. 2nd August 2026
The area beneath the eye is one of the most anatomically delicate regions of the face and one of the most commonly treated. A hollow or shadowed under-eye can make a person look persistently tired, older than they feel, or unwell, regardless of how much sleep they have had. Tear trough filler is a non-surgical option that can address this, but it is also a treatment that requires careful patient selection and precise technique.
This article explains the anatomy of the tear trough, what causes the changes you are seeing, and what you can realistically expect from treatment.
The tear trough is the groove that runs from the inner corner of the eye downward and slightly outward along the junction between the lower eyelid and the cheek. In youth, this transition is smooth and the skin below the eye is supported by a small pad of fat that sits flush with the cheek. With age, that fat pad descends or deflates, the overlying skin thins, and the groove becomes more visible as a shadow or hollow.
The dark appearance under the eyes that many patients want to address is usually a combination of several things: the shadow cast by the hollow itself, increased visibility of the underlying muscle through thinning skin, and in some cases genuine pigmentation. Filler is most effective for the structural component, where hollowing and the resulting shadow are the primary issue.
Volume loss beneath the eye is a natural consequence of ageing. Fat that once sat flush with the lower eyelid gradually descends toward the cheek, creating a gap at the tear trough. Bone resorption around the orbital rim reduces the scaffolding that supports the soft tissue above, deepening the hollow further.
Genetics play a significant role. Some patients present with tear trough hollowing in their mid-twenties with no other signs of ageing. In these cases the concern is structural rather than age-related, and filler can produce particularly satisfying results.
Fluid retention and thinning of the skin around the eye also contribute. These factors do not respond to filler in the same way, which is why an accurate assessment before treatment is essential.
Tear trough filler requires a precise and conservative approach. The under-eye area has a complex vascular anatomy, and the skin in this region is among the thinnest on the face. At Skin Medical, the treatment is performed by clinically trained practitioners who understand the specific considerations of this area.
A very soft, low-viscosity hyaluronic acid filler is used, chosen specifically for the delicate tissue beneath the eye. Placement is typically deep, at or just above the periosteum (the bone surface), to avoid the risk of the Tyndall effect, a bluish discolouration that can occur if filler is placed too superficially in thin skin.
A cannula is often preferred over a needle for this area, as it reduces the risk of bruising and allows the product to be placed more precisely. Most patients require less than 1 ml across both sides.
Some swelling and bruising is common after tear trough filler and can last three to seven days. The under-eye area is particularly prone to fluid accumulation, so swelling may look pronounced initially before settling. Patients should plan for some social downtime in the first few days.
Results become visible as swelling resolves, typically within one to two weeks. When performed well, the improvement is a softening of the shadow and hollow, producing a more rested and refreshed appearance rather than a filled or augmented look. Results last 9 to 18 months depending on the product used and individual metabolism.
A key distinction to understand is the difference between a hollow tear trough and true eye bags. Eye bags are caused by herniation of the orbital fat forward through a weakened septum, creating a convex bulge beneath the eye. Filler does not treat this and, if placed in a patient with prominent eye bags, can worsen the appearance by adding volume to an area that already has excess.
Surgical blepharoplasty removes or repositions the herniated fat and addresses excess skin. For patients with true eye bags, surgery is the appropriate treatment. For patients with a hollow or sunken appearance without significant prolapsed fat, filler is highly effective. Many patients have a combination of both, and a consultation is the only reliable way to assess which is present.
Chin filler is suitable for adults who are unhappy with the projection, shape or symmetry of their chin, but who prefer a non-surgical approach or who are not yet at the point of considering a surgical implant.
It is not a permanent solution. The body gradually breaks down hyaluronic acid, and results typically last 12 to 18 months depending on the product used and how quickly an individual metabolises it. For patients who want a permanent result, surgical augmentation may be a more appropriate long-term option. This is a conversation worth having openly during the consultation so you can make an informed decision.
It is also worth noting that chin filler is best placed by a highly trained practitioner who understands the anatomy of the area. There are important vascular structures in the chin and surrounding regions, and improper placement carries real risks. At Skin Medical, our clinically trained practitioners deliver all injectable treatments with a thorough understanding of facial anatomy.
The concern about lumps forming after chin filler is a legitimate one that appears frequently in patient research. Lumps can occur if a practitioner places filler too superficially, if an inappropriate product is used for the area, or if post-treatment swelling is mistaken for filler migration. Experienced practitioners using products suited to deep chin placement make this far less likely.
If lumps do develop, clinicians can dissolve hyaluronic acid filler using hyaluronidase, which offers an important safety advantage over non-reversible alternatives.
If you are concerned about your chin projection or the balance of your profile, a consultation at Skin Medical is the right starting point. Our clinicians will assess your anatomy, discuss your goals, and recommend whether chin filler, jaw contouring filler, or a combination approach best suits your needs.
A chin filler is an injectable dermal filler treatment using hyaluronic acid to add projection, improve shape, or correct asymmetry in the chin. It is a non-surgical procedure with minimal downtime and results lasting 12 to 18 months.
A weak chin lacks forward projection, making the nose appear larger and the jawline less defined. Chin filler adds volume at carefully chosen points to bring the chin into better proportion with the rest of the face, improving the profile from the front and side.
Discomfort is minimal for most patients. A topical anaesthetic is applied before treatment, and the filler itself contains lidocaine. Most patients report a mild pressure sensation rather than significant pain.
Results typically last from 12 to 18 months, though this varies between individuals depending on the product used and how quickly the body metabolises hyaluronic acid. Maintenance treatment is usually recommended at that point to preserve results.
Common side effects include mild swelling and bruising lasting a few days. More significant risks include lumps, asymmetry, or, in rare cases, vascular complications if the product is placed incorrectly. Choosing a clinically trained practitioner significantly reduces these risks. Hyaluronic acid filler can be dissolved with hyaluronidase if required.
Lumps can occur if filler is placed too superficially or if an unsuitable product is used. They are significantly less common when treatment is performed by an experienced practitioner. If lumps do form, they can typically be resolved by dissolving the filler with hyaluronidase.
This depends on the degree of correction needed and your individual anatomy. Most patients require 1 to 2 ml. The precise amount is discussed and agreed during your consultation based on your specific concerns and facial proportions.
Neither is universally better. Filler offers a non-surgical, reversible, and lower-commitment option with immediate results. Surgery provides a permanent outcome but carries the risks associated with any surgical procedure. The right choice depends on the extent of the correction needed and your personal preferences. A consultation at Skin Medical can help you weigh these options clearly.
Yes. Chin filler is often combined with jaw contouring filler for a more comprehensive lower face result. It can also be combined with other facial filler treatments as part of a broader facial balancing plan.
You can book a consultation directly through skinmedical.com. During the consultation, your clinician will assess your anatomy and discuss whether chin filler is the right approach for your concerns.
