Fast Facts:

About: Tear trough filler is a minimally invasive cosmetic procedure in which a hyaluronic acid-based dermal filler is injected below the eye to replace lost volume and eliminate the appearance of dark circles or “tired eyes”. The treatment can rejuvenate and brighten the under eye region for up to 12 months.

Safety: Hyaluronic acid dermal fillers are FDA approved for cosmetic purposes and are commonly used under the eyes. Under eye filler is safe, minimally invasive, reversible if needed and with minimal risks, side effects, and downtime.

Convenience: As a minimally invasive procedure, under eye filler comes with little risk and limited downtime. The treatment itself takes no longer than 20 – 30 minutes and has very few post-procedural restrictions, making it convenient for almost anyone.

Cost: The average teardrop filler price ranges $800 – $1500 per 1 syringe.

Efficacy: When used to replace lost facial fat and under eye hollowness, tear trough filler injections are very effective and allow for immediate improvement.

Under Eyes, cheeks, smile lines, lips, chin - before and after photo
lip filler before and after photo


What causes dark circles?

Dark circles under the eyes can be due to a variety of factors including genetics, unhealthy habits like drinking and smoking, lack of sleep, or the natural aging process. In addition, fatigue, sun damage, and dehydration all affect how our faces age. As we get older, our faces lose fatty tissue and hyaluronic acid, causing overall volume loss in the areas that keep us looking young and fresh. This loss of volume casts a shadow beneath the eye that appears as a dark circle.

Dark circles under the eyes may also be the result of collagen loss with age, in which case our skin becomes thinner and more transparent, causing darkened under eyes with visible blood vessels.

Fortunately, facial hollowness can be reversed in a minimally invasive manner through the use of injectable fillers designed to treat areas such as the tear troughs.

What is tear trough filler? What is the goal of tear trough fillers?

Under eye hollowness is characterized by dark circles beneath and around the eyes, making us look tired and old. As we age, we lose facial fat and thus, overall facial volume, which causes these deep indentations in the under eye area which cannot be naturally replaced, even with a healthier and better rested lifestyle.

Tear trough fillers are used to provide volume and replace the fullness that is lost below the eyes. Typically hyaluronic acid-based, dermal fillers for the tear trough area have a gel consistency and provide instant volume and hydration upon injection, allowing patients to revitalize and refresh their overall facial appearance. In addition to volume restoration, dermal fillers also stimulate collagen production, thickening the skin and minimizing its translucency for additional rejuvenation.

Why is under eye filler so popular?

While a well-maintained skincare routine can help maintain the quality of your appearance, there is no magical serum or cream that will fill in the dark hollow circles that develop beneath the eyes. As we age, we lose fatty tissue under the eyes, resulting in the development of shadows and lines and an older, more tired look. While surgical procedures are frequently used to rejuvenate the face, there is an easier and less invasive option to fill in your under eye hollows: dermal fillers.

Tear duct filler is particularly popular due to its minimally invasive nature and long-lasting results. Using hyaluronic acid-based dermal filler to replace lost volume around the eyes allows patients to obtain instant results in just 20 – 30 minutes, with limited risks, side effects, or downtime. Hyaluronic acid is naturally produced by the body, making hyaluronic acid fillers very well tolerable with little risk for infection. In addition, tear trough filler is fully reversible. Tear trough fillers before and after pictures never disappoint.

under eye filler injection

How does Under eye filler work?

Most under eye dermal fillers are hyaluronic acid (HA) based, such as Restylane, Juvederm and RHA fillers. Hyaluronic acid is a substance that is naturally produced by the body and is responsible for skin hydration and joint lubrication. When injected into the skin below the eyes, hyaluronic acid binds to and absorbs surrounding water, hydrating the skin and creating an increase in volume. In addition, recent studies suggest that repeated injection of such fillers stimulates the body’s collagen production, increasing the thickness and elasticity of the skin.

HA fillers are cross-linked, meaning that the small natural particles are bound to create larger molecules and thus, allowing for enhanced volume and longer-lasting results that are resistant to degradation by enzymes.

Who is a good candidate for tear trough filler?

The best candidate for an under eye filler treatment is someone who is in overall good health but has hollowness under the eyes and cheeks and would like to restore that lost volume. For the best results, consult with an experienced medical professional who will know exactly how much and what kind of iller will be needed to achieve your desired result. There is a common misconception about dermal filler treatment for under eye bags only being appropriate for women, but if you are wondering how to get rid of eye bags fast for guys, men are just as applicable to fillers as women.

If there is severe wrinkling with fat deposition under the eyes, surgical intervention may be a better option. If you are pregnant or breastfeeding, have a bleeding disorder, or skin condition in the treatment area, you are not a candidate for a tear duct filler.

How do I prepare for tear trough filler?

The only way to prepare for tear trough filler is to discontinue blood-thinning medications such as Advil, Aspirin, or herbal supplements for one week prior to your appointment. This will prevent inadvertent bruising during the procedure.

Under eye filler treatment

What is the under eye filler procedure like?

Consult: You will start off with a consultation with Dr. Schwarzburg to discuss your medical history, prior cosmetic treatments, cosmetic concerns, and aesthetic goals as well as your skin’s elasticity to determine how much filler and what kind of injectable product would best suit your needs.

Procedure: Once confirmed, your tear trough area will be sanitized and Dr. Schwarzburg will inject the selected HA dermal filler directly into your skin in tiny amounts using an ultra-fine needle. While some injectors opt for a cannula rather than a needle, Dr. Schwarzburg prefers using an ultrafine needle to inject the filler for minimal discomfort, better precision, and superior results. This process will take no longer than 30 minutes after which you will be provided with an ice pack to reduce swelling.

Restylane under eye filler

How long does it take to fill the under eye?

An under eye filler typically takes 20 – 30 minutes to inject. In some cases, it may take longer, for example, if the filler is paired with a cheek filler tear trough.

Are there any risks and side effects with Under eye filler?

Hyaluronic acid-based dermal fillers are FDA-approved and safe with a low risk for product-related reactions. After your filler, you may experience redness, swelling, tenderness, and bruising, all of which will improve within a few days.

In rare cases, there may be a bluish tint after injection, which is called the Tyndall effect and is secondary to the filler that was injected too superficially or with very thin skin. This inconvenience is easily reversed by injecting Hyaluronidase, the enzyme that dissolves HA filler.

Possible, but rare side effects also include changes in vision, infection, allergic reactions, and persistent pain, in which case you should contact your provider about the treated area immediately.

What should I do after my under eye filler treatment? Is there downtime?

While you are free to return to normal activities and work immediately after your tear trough filler, you should avoid strenuous exercise, alcohol, and heat for 24 – 48 hours after your treatment to allow the product to settle properly and to avoid excess swelling. You may apply an ice pack for the first 24 hours, followed by a warm compress on day 2 should there be any bruising.

Are Facial Fillers helping with dark under eye circles

How much does under eye filler cost?

The cost for under eye filler can vary anywhere from $800 to $1500 per 1 syringe containing 1ml of product. The price depends on the clinic location and how many syringes you need. You may need anywhere from 1 to 3 syringes for optimal results. It also may depend on what type of filler for tear trough is used as prices vary depending on the type and longevity of each HA product. In addition, a dermal filler injected by an experienced board-certified physician will be more costly than a nurse, due to the extensive knowledge and expertise of a doctor.

Which dermal fillers are used for tear trough rejuvenation?

While any hyaluronic acid filler tear trough can be used to fill the tear trough, the two most commonly used dermal fillers for this delicate area are Restylane and Juvederm. You may be wondering, which is the best dermal filler for tear trough? There is no single filler that is better than the other, though they each have their own individual benefits.

What is the best filler for tear trough?

Which HA filler your provider chooses is important to the end result. Dr. Schwarzburg prefers fillers from the RHA and Restylane family for this procedure because you don’t risk what she calls the “Tyndall effect,” or the blue-gray shadow that can occur when Juvederm is placed too close to the surface of skin.

  • There are a few different types of Restylane fillers, including Restylane, Restylane Silk under eyes, Restylane Lyft, Restylane Refyne, and Restylane Defyne. Most Restylane tear trough products can be used in the lower eyelid and other deep creases, although Restylane Lyft under eyes has a texture that is slightly too thick and dense to inject in the delicate area that is your under eye.
  • Juvederm is a commonly used and FDA-approved hyaluronic acid filler. It is commonly used for lip fillers, but can also be used for the under eyes. Juvederm is produced by the pharmaceutical company Allergan, the same company that manufactures Botox and Kybella. There is no right answer to whether Juvederm or Restylane is better for the tear trough and cheek filler, because it is completely variable based on every patient’s individual needs and teardrop under eyes. Juvederm Voluma under eyes is also popular.

Which complementary treatments can be performed with tear trough injections for facial rejuvenation?

Under eye tear trough dermal fillers can be combined with all kinds of other procedures and cosmetic injectables for eye rejuvenation. While filler itself is the best solution to address under eye circles and hollowness, people often combine the treatment with an upper cheek filler for symmetry and smoothness.

Around the eyes, many people get tear trough Botox injections to minimize, prevent, and eliminate the lines formed around the corners of the eyes, called Crow’s feet. Other cosmetic options for under eye bags around the eyes include the plasma pen, which can tighten the delicate skin under the eyes, Fraxel laser treatments for under eye bags, which is a medical laser facial used on the face, neck, and décolette to improve fine lines, wrinkles, sun damage, pigmentation, and crepiness in the skin, and Secret RF microneedling, an advanced form of microneedling involving radiofrequency energy for added heat and additional collagen and elastin stimulation and production.

There is no particular non-surgical treatment for under eye bags, fat pads, or festoons that will eliminate them. While microneedling for under eye bags will not address loss of tissue volume, but it can help restore and tighten the skin around the eyes and reduce tear troughs and the appearance of fine lines and wrinkles. You can look up microneedling under eye bags before and after and before and after under eye wrinkles photos to see the type of results microneedling can offer under the eyes.

Botox with under eye filler treatment

Botox can be used with any under eye filler treatment as long as it is injected before the under eye filler (if it is injected around the eye for crows feet). Many people combine under eye filler with Botox in the crows feet to freshen up the overall appearance of the eye. Some patients also like to get a botox eyebrow lift to widen the eyes and awaken the face.

Eye creams with under eye filler treatment

Eye creams and skincare products can always be beneficial in addition to under eye fillers. Because the skin underneath the eye is so sensitive and delicate, be sure to find a product that caters specifically to the skin around your eyes to keep your under eyes moisturized and healthy. Eye creams can help to keep the skin underneath your eyes moisturized, but if you want a true under eye restoration you will likely have to go with cosmetic under eye fillers.

Under eye filler versus blepharoplasty

A blepharoplasty is a surgical procedure that involves trimming excess skin, droopy eyelids, and puffiness. It is invasive and involves several weeks of downtime, which is why you should always consult with a board-certified physician prior to any procedure to confirm whether you are a candidate and to set realistic expectations and fully understand the risks and side effects.

Under eye filler is used to fill in hollowness below the eye and does not involve the risk or downtime associated with plastic surgery or eyelid surgery. In addition, an under eye filler lasts 9 – 12 months, while a blepharoplasty is permanent. Teardrop filler is minimally invasive and does not require any form of anesthesia.

A blepharoplasty is ideal for patients with excess laxity under the eyes or festoons which can not be addressed using a dermal filler.

What are under eye fillers made of?

Most fillers are made of hyaluronic acid, a substance naturally found in the dermis. As a filler, hyaluronic acid molecules are cross-linked allowing them to maintain volume for an extended period of time by absorbing water surrounding the injection site, enhancing volume in the treated area.

What are the benefits of nonsurgical facial rejuvenation?

With nonsurgical facial rejuvenation, you can get results that are comparable to plastic surgery without the risks and downtime associated. You will also be able to adjust your filler as you go, rather than settling for one permanent and irreversible result.

How many under eye filler syringes do I need?

The number of syringes needed to achieve your desired result depends on your starting point, your desired outcome, and your individual response to the filler. Dr. Schwarzburg likes to take a “less is more” approach when it comes to any dermal fillers to achieve a natural yet transformative result. Typically he starts off with one syringe (1 mL) of HA-based dermal filler and adds more if needed after a two-week follow-up appointment.

Does under eye filler hurt?

Most dermal fillers contain lidocaine, a numbing agent which makes the injection process more comfortable. While a topical numbing cream can be applied before the treatment, Dr. Schwarzburg usually refrains from numbing cream under the eyes, as it may swell up the area, making the injections less precise. Overall, under eye fillers are not painful and are tolerated well by most patients. Tear duct filler before and after injection typically does not involve much pain, though there may be some tenderness.

When will I see results? How long does tear trough filler take to settle?

The results of your dermal filler are immediate, though they may be disguised by swelling and bruising for the first few days. The filler itself will have settled within 3 days and the full results can be observed once swelling and bruising have subsided, which can be anywhere from 2 days to 2 weeks.

What will my under eye trough filler before and after results look like?

Before your under eye filler you will have hollowness in the form of dark circles under your eyes. Whether this be due to genetics, aging, or lifestyle, this lack of volume will make you appear older and tired. Once you have undergone your teardrop filler procedure, these eye circles will be reduced or eliminated leaving you with a rested, more vibrant, and rejuvenated look.

Do Under Eye Fillers Remove Dark Circles?

In most cases, “dark circles” under the eyes are not due to discoloration, but lack of facial fat and volume, leaving us with hollow shadows beneath the eyes. Under eye fillers work by adding volume to the under eyes, removing eye circles as the area is filled in.

How long does tear trough filler last?

The longevity of your tear duct injections depends on your metabolism, where, and how much filler was injected. Areas that involve a lot of repetitive movement tend to metabolize filler quicker, though the under eyes typically last 9 – 12 months in the average patient.

Can you reverse tear trough filler treatment?

In most cases, dermal fillers used in the tear trough area are hyaluronic acid based. Hyaluronic acid can be dissolved using hyaluronidase, which fully reverses the effects of any HA filler upon injection. Dr. Schwarzburg has used hyaluronidase on patients who had poorly placed fillers performed elsewhere to allow patients to either go back to their original state or to have Dr. Schwarzburg reinject the under eyes properly.

Is it covered by insurance?

Under eye filler is a cosmetic procedure and therefore is not covered by insurance.

Are tear trough fillers safe?

Under eye filler is safe and comes with very low risk factors. You may experience some bruising or swelling after the procedure, which can be reduced using an ice pack, a warm compress, and arnica gel. Your tear trough injections should always be performed by a trained, board certified physician to ensure proper technique and minimize risks and side effects.

When is Under eye filler not effective?

There are some cases in which your dark circles are not due to hollowness, but due to hyperpigmentation in the under eye area. If this is the case, then Dr. Schwarzburg may recommend a different treatment plan to address hyperpigmentation, such as Fraxel, as under eye filler will not remove discolored under eyes. When there’s excess fat pad herniation, that happens with festoons, the under eye filler may not be a viable option and a surgical approach should be pursued.

Does Under eye filler work?

Yes! By adding volume to hollow under eyes, tear trough filler works to eliminate dark circles and create an overall more youthful appearance.

What are pros and cons of under the eye filler injections?


  • Minimally invasive
  • Minimal side effects and downtime
  • Does not require anesthesia


  • Not permanent
  • Does not treat under eye pigmentation


Tear trough filler is a common treatment used to add volume to under eye hollows, reducing or eliminating the appearance of dark circles. The injection process takes 20 – 30 minutes and comes with little to no downtime. It is important to get this treatment performed by a board-certified cosmetic physician who has an excellent understanding of the human anatomy for optimal results.

How can I get started with my Secret RF treatment?

If you are looking for the best place for tear trough fillers or NYC under eye filler, then Skinly Aesthetics on the Upper East Side is your definitive answer. Owned and operated by Dr. Schwarzburg, a board-certified cosmetic physician with over a decade of experience known as the best doctor for under eye fillers, Skinly offers a variety of minimally invasive procedures for the face and body. To schedule your consultation with Dr. Schwarzburg, you can contact us at (212) 774-4264 or email