Tear trough fillers, also known as under eye fillers, are injections used to treat under eye hollows or dark circles. They work by filling the hollow area under the eyes with hyaluronic acid, a substance that helps restore volume and hydration. When expertly administered, fillers can minimize shadows and reduce the look of tired eyes. However, tear trough fillers come with risks and downsides that you should consider. Here are some quick answers about why you may want to avoid tear trough fillers:
- Results may not last very long, often less than a year
- Repeated treatments are usually needed to maintain results
- Fillers can sometimes cause under eye swelling, lumps, or shadows
- The delicate under eye area has risks for serious complications like blindness
- Treatments can be expensive, averaging $600-$800 per syringe
- Natural or less invasive alternatives exist like retinol creams or laser resurfacing
Keep reading to learn more details on the downsides and risks of tear trough fillers and why they may not be the right choice for you.
Short-Lived Results
One of the biggest drawbacks of tear trough fillers is that the results do not last very long. Most patients only see improvements for 6 months to 1 year before the filler is gradually absorbed and dark circles or hollows reappear.
Some doctors speculate that because there is a lot of motion and fluid dynamics under the eyes, the hyaluronic acid tends to break down faster than it does in other areas of the face. The thin skin and lack of fat under the eyes also means there is less cushioning to hold the filler in place long-term.
Since the effects are temporary, if you wish to maintain results, you will have to get repeat filler injections every 6 to 12 months. This makes treatments a lifelong commitment and expense if you wish to keep under eye hollows away. Some patients do report results lasting up to 2 years, but this is less common. Discuss your individual case with an experienced cosmetic doctor.
Risk of Complications
While considered a relatively safe procedure when done correctly, tear trough fillers do carry risks ranging from minor to extremely rare but serious. Understanding the potential complications can help inform your decision on whether potential rewards outweigh possible risks.
Some possible side effects and complications include:
- Bruising or swelling – Short term bruising or swelling is common after filler injections. Proper injection technique can minimize this. Bruising often resolves in 5-10 days.
- Under correction – Not enough filler can lead to inadequate reduction in hollows or dark circles. You may need additional syringes or treatments.
- Over correction – Too much filler can give an unnatural look or cause bulges under the eye. Hyaluronidase injections can help dissolve excess filler.
- Lumps or nodules – Small lumps may form under the skin if the filler is not properly spread out. Massage can help smooth these out.
- Migration – Filler spreading to other areas can lead to swelling or growths in other parts of the face.
- Discoloration or bluish hue – Injecting too superficially can cause dark circles to look worse.
- Infection – Rare after proper sterilization, but bacteria introduced during injections can lead to infection.
- Vision loss – Extremely rare but filler accidentally injected into an artery could cause retinal artery occlusion and blindness.
Choosing an experienced doctor who knows the delicate under eye anatomy helps reduce these risks. But side effects remain a possibility with any injectable filler procedure.
Repeat Treatments Are Needed
As mentioned briefly already, the effects of tear trough fillers do not last permanently. The body gradually absorbs the hyaluronic acid over time.
Most patients need to repeat the procedure every 6 months to 1 year to maintain improvements in hollows and dark circles. A few lucky patients may go up to 2 years between treatments. But you should expect and budget for regular touch up injections.
This makes tear trough fillers an ongoing expense rather than a one-time cost. Repeat treatments every year may cost $600-$800 per session when you factor in the injectable material and fees for the doctor’s time and expertise.
The costs can add up quickly. Make sure you have realistic expectations on the long term commitment and budget required to sustain results with tear trough fillers before proceeding.
Better Alternatives Exist
Another reason to potentially avoid tear trough fillers is that better non-invasive treatment options exist for improving the look of under eye hollows and dark circles. Less risky alternatives include:
- Topical retinoids – Prescription retinol creams boost collagen production and skin thickness over time, helping fill under eye hollows.
- Laser skin resurfacing – Lasers remove outer layers of skin to improve texture, wrinkles, and shadows.
- Chemical peels – Light chemical peels exfoliate the skin to reveal fresher layers and reduce pigmentation.
- PRP injections – Injecting platelet rich plasma taken from your own blood stimulates tissue regeneration.
- Fat grafting – Transferring fat to the under eye area can have longer lasting filling effects than hyaluronic acid.
- Address allergies – Allergy medication and allergen avoidance can reduce under eye shadows and swelling.
- Improve sleep habits – Getting enough quality sleep minimizes dark circles related to fatigue.
For mild hollowness, topical creams or proper skincare may be sufficient. More intensive treatments like laser resurfacing or fat grafting can provide longer lasting improvement for moderate to severe hollows with fewer risks than injectable fillers. Discuss all your options with a doctor.
Better Candidates Exist
While tear trough fillers can be an effective treatment for some people, they are not the ideal choice for every patient. More suitable candidates include:
- Patients with mild to moderate under eye hollows and good skin elasticity
- Healthy individuals who do not have serious allergies or sleep disorders
- People seeking a temporary fix with disposable income to afford routine touch ups
- Those who have researched risks and are comfortable with possible side effects
- Realistic patients who understand results will not last permanently
People who already have very thin under eye skin, deep tear troughs, poor skin quality, or health conditions causing their dark circles may get better outcomes from alternative treatments. Have realistic expectations on results from fillers based on your unique facial anatomy and under eye situation.
What Are the Long Term Risks?
While rare, some risks and side effects may potentially emerge years after getting tear trough filler injections. That is because even once the filler itself is absorbed by the body, it leaves behind lasting impacts.
Potential long term risks include:
- Thinning skin – Repeated injections may cause skin to thin over time and worsen hollow look.
- Sunken appearance – Overfilling can expand tissues, which later collapse causing more prominent hollows.
- Chronic edema – Filler material can trigger chronic inflammatory responses and fluid retention.
- Granulomas – Hard lumps under the skin may form years later as an immune reaction.
- Delayed infection – Low grade infections could develop over time.
- Vision changes – Retinal artery occlusion has delayed onset in rare cases.
These chronic issues tend to arise after multiple filler treatments. They may relate to the body breaking down the filler substances over years. It is difficult to predict if or when such problems may show up. This contributes to the uncertainty involved with these cosmetic injections.
What About Using Your Own Fat?
An alternative type of filler for under eye hollows is autologous fat transfer. This involves taking fat from your own body, purifying it, then re-injecting it into the tear troughs. Since it uses your natural tissues, it avoids risks associated with synthetic fillers.
Potential benefits of fat grafting include:
- Longer lasting results, up to 2-3 years
- Natural feel and appearance
- Avoid risks of allergic reactions or rejection
- No repeat treatments needed as often
However, a downside is that about 30% of transferred fat is reabsorbed by the body. Touch up treatments may eventually still be needed for upkeep. Fat grafting also requires a more complex procedure of liposuction and processing fat before injection. Results are technique dependent and some doctors have better success rates than others.
Overall fat grafting can be a viable alternative to standard fillers for some patients. Discuss options with your cosmetic doctor.
Can You Remove or Dissolve Fillers?
If for any reason you become dissatisfied with tear trough filler results, there are ways to help remove or minimize the effects.
Waiting for absorption – As mentioned already, hyaluronic acid fillers gradually break down on their own within 6 to 24 months. Letting the filler dissipate over time is one removal option if side effects are tolerable.
Hyaluronidase – Injections of this enzyme quickly dissolve hyaluronic acid. It can eliminate unwanted filler within a few days. Multiple treatments may be needed.
Massage – Kneading and pressing the area can help break up or smooth out lumps. Vigorous massage is not advised as it could cause other complications.
Laser or ultrasound – Energy-based treatments may help liquefy stubborn nodules and speed up filler absorption. Ultrasound may have better results based on small early studies.
Always discuss filler removal approaches with the original injecting doctor when possible. Removal carries risks like inflammation, skin injury, or incomplete resolution. Unfortunately some filler complications cannot be fully corrected. This is why starting with a conservative amount and skilled injector is best.
What About Non-Invasive Alternatives?
Using skincare products, lasers, or other treatments without injections may provide mild improvement in some cases:
Retinoids – Topical vitamin A/retinol products boost collagen production, which can gradually reduce the appearance of fine lines and hollows over months.
Peptides – Some peptides like Haloxyl may minimize dark circles by strengthening capillaries and increasing circulation.
Hydroquinone – This bleaching agent can lighten skin to reduce the hollow shadow look. It has risks of irritation though.
Laser resurfacing – Ablative or fractional lasers remove damaged outer skin layers. New skin looks smoother with fewer wrinkles.
Photobiomodulation – Red and near infrared light may stimulate cell regeneration to improve under eye skin.
Chemical peels – Light peels with glycolic acid can gently freshen the skin’s appearance.
For significant hollowness, non-invasive options may not provide as dramatic an effect as dermal filler injections. But they are worth exploring before considering more invasive procedures. See your dermatologist or cosmetic doctor for advice.
What About Using Fillers Elsewhere on the Face?
While tear trough fillers carry unique risks, injectable dermal fillers in other facial areas are generally considered safe when properly done. Common areas fillers are used include:
Nasolabial folds – Filler injected into the lines running from the nose to mouth can temporarily restore a smoother appearance.
Marionette lines – Filling the folds at the corners of the mouth to chin can minimize sagging.
Lips – Hyaluronic acid lip fillers enhance shape and volume, providing a plumper look.
Cheeks – Adding fullness to the mid-face and cheekbones can create a more youthful contour.
Chin – Augmenting or reshaping the chin with filler creates a balanced facial profile.
Jawline – Structural fillers can sharpen the look of the jaw and jowls.
When following proper protocols for injection depths and volumes, facial fillers are considered safe with temporary effects lasting 6 months to 2 years on average. Avoid unqualified providers improperly using fillers though. Research and choose an experienced cosmetic injectionist.
What Questions Should You Ask Providers About Fillers?
When consulting doctors about potential tear trough filler treatment, asking the right questions is key to an informed decision. Important questions to ask include:
- How many years have you been performing tear trough filler procedures?
- How many procedures do you do annually and what is your complication rate?
- What specific products do you use and why did you choose them?
- What technique do you use for injecting safely in this delicate area?
- What results can I reasonably expect and how long will they last?
- How much does the procedure cost and what is your policy on touch ups?
- What side effects may occur and how will you handle complications if they arise?
Choose a doctor who thoroughly explains the risks, sets appropriate expectations, uses proven techniques and materials, and has significant expertise in tear trough treatments. Make sure all your questions are answered during your consultation.
Conclusion
In summary, while tear trough fillers can provide subtle improvements in hollowness and dark circles, they have significant drawbacks to consider. Results fade within a year or two requiring repeat treatments. Risks range from bruising to rare but serious vision complications. Less invasive options with potentially better long term outcomes exist like laser, peels, or retinoids.
For some patients, the nonsurgical revival of a rested, youthful eye area with fillers is worth the cost and upkeep. But make sure you fully understand the pros, cons, and alternatives before proceeding. Tear troughs often worsen with age regardless of filler intervention. Setting realistic expectations is key. Your safest bet is always finding a skilled injector you can trust for a natural looking outcome.
