Under-Eye Filler for Tear Troughs

Look rested, not tired.

Under-eye filler, also called tear trough filler, is a soft hyaluronic acid gel placed in the hollow between the lower lid and cheek. It smooths the shadow that makes you look tired, even when you've slept well. I most often use Restylane Eyelight.

Think of catching your reflection in an elevator and looking as rested as you feel, reaching for less concealer, and hearing "you look great" instead of "are you tired?" That's the goal: you, refreshed.

My approach: why I often start with the midface

Under-eye hollows are often about the cheek, not only the eye. As the midface loses support, the lid-cheek junction deepens. So I usually restore the midface first. In many cases, that alone brightens the under-eye area so much that very little or no tear-trough filler is needed afterward.

What I want you to know up front - I most often use Restylane Eyelight, a filler made for this area. - Many people need less under-eye filler than they expect once the midface is supported. - I plan two sessions, not a single touch-up, because that gives the most natural result.

What does under-eye filler treat?

Hollows and shadows under the eyes, often from genetics or changes over time. It's best for a groove or hollow, and less helpful for puffiness or bags. If another option would serve you better, like Fotona Eyelase or skincare, I'll tell you. It suits people of every skin tone, and I tailor product and placement to your face.

Why the under-eye area needs extra care

The skin under your eyes is some of the thinnest on your body, and right under the tear trough there's little or no fat to cushion it. Just behind a thin membrane called the septum sit three small fat pads, and a tight band of tissue, the tear trough ligament, anchors the skin to the bone along the inner part of the rim. That ligament is what creates the groove. Tiny blood vessels run through this area too.

All of this means placement matters. Filler placed too close to the surface can show through as a bluish tint (called the Tyndall effect) or as small lumps. Too much, or in the wrong layer, can look puffy, because this area tends to hold onto fluid. And knowing where the vessels run guides where and how deep I work.

That's why I'm deliberate here. I use Restylane Eyelight, a soft filler made for this area, and most often place it with a blunt-tipped cannula, which glides along the right layer with fewer entry points; sometimes a fine needle is the better choice for a specific spot. I usually plan two sessions about 6 to 8 weeks apart, so the first can settle before I refine. And because I often restore the midface first, many people need very little or no filler in the tear trough itself.

How I place under-eye filler: cannula or needle

Most often I use a cannula, a fine, blunt-tipped tool that lets me place the gel smoothly with fewer entry points. Sometimes a needle is the more precise choice for a specific spot, and I'll use whichever gives you the best result.

How many sessions will I need?

Usually two, about 6 to 8 weeks apart. This isn't a touch-up. Building in two steps lets the first session settle so the second can refine it, for the most natural result. Some swelling or bruising can happen for a few days, so plan ahead before a big event.

Pairing filler with skin treatments

Filler restores volume in the tear trough, but it doesn't change the skin itself. The skin under the eye is thin, and over time it can look crepey, with fine lines and uneven texture. Tixel and the UltraClear laser are excellent for that skin: they improve crepiness, fine lines and texture under the eye. My team often combines them with under-eye filler, so you get both the volume and smoother skin.

How long does it last?

Restylane Eyelight is designed to last up to 18 months. In my experience, results often last well beyond that.

See all filler treatments, the RHA® Collection for the midface, or pair it with Moxi for skin quality.

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Medically reviewed by Doris Day, MD