The tear trough is the groove that runs from the inner corner of the eye down and outwards across the top of the cheek. In some people it is there from their twenties; in most it deepens with age as the fat pads of the cheek shrink and the thin skin under the eye loses support. The effect is a shadow that makes you look tired however well you have slept, and that concealer only partly hides.
Why under-eyes are different
The skin under the eye is the thinnest on the body, with very little fat beneath it and a network of small vessels close to the surface. That makes the area unforgiving: too much product, the wrong product, or product placed too close to the surface can leave lumps, puffiness or a bluish tint that shows through the skin. It is an area where experience and restraint matter more than almost anywhere else on the face, and where “less” is nearly always the right answer.
What helps
For many people, polynucleotides are now our first choice for the under-eye. Rather than filling the hollow, they improve the quality, thickness and hydration of the thin skin over a short course of treatments, which softens the shadow and reduces crepiness without adding volume. They are particularly good where the main problem is darkness and fine lines rather than a deep groove.
Where there is a genuine hollow, a small amount of soft dermal filler, placed deep against the bone, can restore the support that has been lost and smooth the transition from eye to cheek. Often the better route is to restore the cheek itself, which lifts the under-eye indirectly and more naturally.
If puffiness or bags are the main issue, filler is not the answer and we will say so; that is usually a question for a surgical opinion.
What a consultation involves
We will look at the under-eye area in good light and in profile, assess the skin and the degree of hollowing, and tell you honestly whether you are a good candidate and which approach we would recommend. Nobody is treated under the eyes without a proper consultation first.
