Dark shadows under the eyes quickly make a face look tired – even after a restful night. Often a pronounced tear trough is behind it. Many therefore ask whether the tear trough and dark circles can be filled. The honest answer: often yes, but not always. What is decisive is what causes the shadow.
Treatment at Alpha Skin: Tear trough filler in Bonn – price from €199 and appointment
This article explains the most common causes, when filling with hyaluronic acid makes sense, when it achieves nothing, how it works and what it costs.
What the tear trough is
The tear trough is the hollow that runs diagonally downwards from the inner corner of the eye to the cheek. Over the years the tissue there loses fullness, and the fat pad of the cheek sinks somewhat. The groove becomes deeper and casts a shadow that looks like a dark ring. In some people it is already present at a young age.
Other causes of dark circles
- Thin skin: The skin on the lower lid is very thin. Blood vessels and muscle show through bluish or violet.
- Pigment: Brownish dark circles arise from increased pigment, often familial or intensified by sun.
- Swelling and eye bags: Water retention or protruding fatty tissue form pads, under which there is also a shadow.
Lack of sleep, allergies, smoking and a lot of salt can also intensify dark circles. Which cause predominates in you is shown by the examination in good light.
When filling can help
Best suited is the shadow of a tear trough. A soft hyaluronic acid fills the missing volume at the transition to the cheek. The groove becomes flatter, the shadow smaller, the eye looks fresher. A blunt cannula that spares the tissue is usually used for this. It is often sensible to support the cheek slightly in addition, because part of the volume is missing there.
When filling does not help
With brownish pigment, hyaluronic acid does not fill anything that changes the colour. With pronounced eye bags, additional volume can even emphasise the swelling. And vessels showing through bluish remain visible if the skin is very thin. Botulinum toxin ("Botox") also does not help against dark circles; it is used at the eyes for crow's feet.
Other routes depending on the cause
- Thin, dull skin: Skin boosters improve skin quality and can make the skin on the lower lid look stronger.
- Fine skin, first signs of ageing: The PRF eye treatment with own blood can support skin quality around the eyes; with a pronounced tear trough it does not replace filler.
- Pigment: Here a precise clarification, consistent sun protection and targeted care help. More in the Melasma and pigment consultation.
- Swelling: Treating allergies, sleeping enough and less salt in the evening often help more than any injection. Pronounced eye bags can only be reduced surgically.
How the treatment works
- Consultation and examination: The physician looks at the region calmly and in different light and explains what is realistically achievable.
- Preparation: The skin is disinfected; on request it is cooled or anaesthetised.
- Treatment: With a fine cannula a small amount of hyaluronic acid is introduced and carefully distributed. This usually takes 20 to 30 minutes.
- Check-up: After about two weeks it can be assessed whether a small correction makes sense.
The result is visible immediately and settles after the swelling has subsided. In this region it often lasts 9 to 12 months, sometimes longer, because little moves under the eye.
Risks and side effects
Swelling, redness and small bruises are common and usually subside within a few days. Occasionally small unevenness or a bluish shimmer remains if the material lies too superficially. Such results can be dissolved with the enzyme hyaluronidase, more on this under Hylase.
Very rarely, a filler can block a blood vessel. Sudden severe pain, a white or bluish discolouration of the skin or visual disturbances after the treatment are an emergency and need immediate medical treatment. That is why filling the tear trough belongs in experienced medical hands.
When treatment is not carried out
Treatment is not carried out during pregnancy and breastfeeding, nor in cases of inflammation or herpes in the treatment area. In the case of pronounced eye bags or very thin, slack skin, the physician often advises against filling. Blood-thinning medication increases the risk of bruising and should be mentioned in the conversation.
Frequently asked questions
Does filling hurt? With cooling and the anaesthetic in the filler it is usually quite bearable. Many mainly feel pressure.
Am I presentable afterwards? Usually yes. But expect slight swelling or a small bruise and do not plan important appointments directly afterwards.
What if I do not like the result? Hyaluronic acid can be dissolved with hyaluronidase. That is an advantage over materials that cannot be dissolved.
How long does the result last? Under the eye often 9 to 12 months, sometimes longer. A refresher usually needs less material.
From what age does this make sense? There is no fixed limit. A congenital tear trough can bother you as early as your mid-20s, loss of volume shows more from 35.
Can I wear make-up afterwards? Better not on the day of treatment, from the following day usually yes.
Cost
Treatment of the tear trough starts at Alpha Skin from €199. The final price follows the German medical fee schedule (GOÄ) and the amount needed. Health insurers do not usually cover aesthetic treatments. You will find procedure, prices and appointments on the page Tear trough treatment. Whether your dark circles respond to filling is clarified in the consultation at the practice at Theaterplatz 1b in Bonn-Bad Godesberg.
Important medical note
The information described is for general education and does not replace personal medical advice, examination or consultation. Whether a treatment is suitable depends on skin type, initial findings, pre-existing conditions, medication and individual goals.
Effect, durability, tolerability and possible side effects can vary from person to person. Specific results or a particular time course cannot be guaranteed.