Tear troughs are depressions or hollowing that starts from the inner eye moving outwards and down towards the cheek.  Over time with age, this area of the face looses volume as the fat pads shrink, creating a darker shadowing to the under eye. This area of the face becomes an area of concern for people as it often makes them feel older or more tired than they are.

Aside from aging, there are many other causes of tear trough imperfections. Lack of sleep, genetics and lifestyle factors can contribute to the darkening, sagging and sunken appearance of the skin in this area. Some people are just born with naturally hollowed and volume deplete tear troughs.

To improve the appearance of tear troughs, dermal filler can be injected just above the orbital rim. The filler is then massaged into the fatty tissues, replenishing the volume deficit. The treatment can rejuvenate the appearance of this area by plumping up hollow under-eye areas, while concealing dark circles by filling in the loose skin.

Tear trough filler is an extremely difficult procedure due to the delicate nature of the surrounding peri-orbital skin. This area is also prone to water retention and puffiness which can be exacerbated by the placement of too much filler.
In some cases, tear troughs can be greatly improved by treating volume deficit in the upper cheek. Cheek filler can be used in this case to provide further support to the under eye area, thus reducing the appearance of tear trough depression.
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