Tear Trough Fillers Will Have You Ditching Concealer

“You look tired today,” is a comment nobody ever wants to hear—especially when you’ve spackled on layers of makeup. So wouldn’t it be great to jump out of bed in the morning and fly out the door without any cover-up—and somehow look totally energized? You might want to toss your undereye creams and concealers in favor of the latest skin innovation that will totally wake up your beauty routine, banish undereye circles and bags: Tear trough fillers.

Intrigued? Here’s what you should know about the (minimally invasive!) treatment.

Tear trough fillers are typically hyaluronic acid gels used as an injectable treatment to improve the appearance of tired eyes, says plastic surgeon Dr. Ryan Neinstein, MD FRCSC of Neinstein Plastic Surgery on the Upper East Side. 

The gel is precisely placed near the cheekbone and the soft tissue between the eyelid and the cheek. It fills in that hollow area, which gets more prominent as we get older, creating that “yes, I got 12 hours of sleep last night and awoke to the sounds of birds chirping outside my window!” look. Even if that’s never been your look, no matter how much sleep you get. 

Some of us are just born with heavy bags and dark circles under our eyes. Many patients say they look tired even when they have had a night's sleep, says Dr. Neinstein. If you’ve tried everything—even concealers that cost more than front-row tickets to Celine Dion—you might be tempted to deal with a needle to get those results.

The face is cleaned and removed of any makeup. Then, the skin to be treated around the eyes is numbed for 20 minutes. The filler is injected multiple places. 

“We will place some filler deep on the bone to help support the structure of the face, giving [it] a robust, youthful look. To help blend the eyelid and the cheek, we will inject more superficially,” says Dr. Neinstein. After that, ice is placed on the eyes for 5 minutes.

Patients will take a one-time dose of steroids to reduce swelling. They are also asked not to use blood thinners, like aspirin or St. John's Wort, for five days before the procedure, and avoid exercise until the next day. 

Because the skin is numbed, patients only experience some mild discomfort. (By that, we mean a feeling of  “fullness” in the area and some soreness from the deep injections on the bone. This feeling tends to go away in a few hours.) Dr. Neinstein only uses cannulas (so, no needles under the skin), which causes less trauma to the tissues. 

The volume change (rested look) is immediate but full tissue integration and settling is about a week.

Generally, the cost is $800 per session, performed once a year to maintain results.