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Fillers to treat under eye bags

At Harley Street Face Clinic, many patients come to us with a shadow or depression that appears beneath the lower eyelid, this is often termed the tear trough.

Why choose dermal fillers for a lower eyelid lift?

This appearance can give a tired appearance, and patients often find people comment that they look tired or stressed. The reason for these changes is often related to genetics and sometimes lifestyle (e.g. smoking).

The junction between our lower eyelids and upper cheek is referred to as the tear trough area. Tear trough hollowing is one of the earliest aging changes and often is a common feature from childhood. As we get older, this area alters in appearance, by becoming more hollowed, darker, deeper and less revitalised. In some people depressions can develop can make the eyes look somewhat sunken and create unattractive dark shadows, giving the appearance of tiredness, exhaustion and old age.

Treatment at a glance


Rejuvenate natural loss of volume & increased beautification of your face


Longer-acting HA-fillers. Using the Phi Golden Ratio to give natural-looking results


Gold standard FDA-approved fillers, using 'no-needle cannula
technique' with facial specialist expertise


Lasts around 12-months (although exact duration varies from person-to-person)


Quantity dependent. Average quantity 1-2 vials of filler


Special topical anaesthesia using the cannula technique. Moderate discomfort


Mild redness, swelling (1-5 days), occasional bruising


Most patients back normal activity the next day

Complimentary Techniques

Fillers to chin & lips, skin rejuvenation


We offer long-term surgical enhancement (lower blepharoplasty)

There are essentially two ways in which this can be improved

  • Non-surgically with tear trough filler
  • Surgically with lower blepharoplasty (eyelid surgery)

Filler treatment is a popular solution for early treatment of these changes to the tear trough. The treatment involves carefully injecting a gel-like substance into specific areas around the eyes, with the objective of softening deep wrinkles and lines. Filler treatment to the lower eyelid is a more challenging technique and many non-specialist clinicians do not offer this treatment as it is more challenging than other parts of the face.

Filler can also be combined with other treatments including wrinkle injection, as well as skin resurfacing and other facial rejuvenation techniques to provide a ‘liquid facelift’ or facial rejuvenation.

We use several different fillers for various areas of the face, each specialised for a particular anatomical area. There is a wide array of different filler preparations that are currently available on the market and at your consultation, we will advise you on which will provide the best aesthetic solution for you.

The treatment can result in bruising and swelling. This technique is important in reducing recovery time. We have developed a customised a state-of-the-art no-needle technique, this focuses on the use of a blunt cannula to provide the treatment, this minimises bruising and swelling to less than 5% of patients.

Before & after

Real Patient photo gallery

Infection is rare after filler treatment, care is required with hygiene and cleaning the skin before the procedure that avoids these issues. Care is required with technique in this area to avoid complications and ensure a fast recovery.

When shaping the contours of the face the crystal-clear gel is injected into the skin in tiny amounts. The treatment takes a few minutes and the results can be seen immediately.

Lower blepharoplasty (eyelid surgery) can be used, however, this anatomy is both intricate and detailed, for younger patients with mild changes, non-surgically offers a fast recovery procedure avoiding surgery. Patients with more advanced changes are better suited to lower blepharoplasty, as the filler has limitations to improvement.


What does tear trough filler involve at The Harley Street Face Clinic?

Our team will use a numbing local anaesthesia cream to reduce discomfort from the procedure. The numbing cream is specially made for The Harley Street Face Clinic and was designed in Beverly Hills and manufactured in Germany. After this, a small anaesthetic injection is applied in the already numb area. The dermal filler is then used to augment the chin and jawline. We use our ‘fast-healing’ techniques that utilises a cannula to administer the filler for most patients, this results in much less swelling and bruising than older needle-based techniques.

Additionally, dermal fillers can be used on other facial areas at the same time as on the cheeks, to give an enhanced natural result. At The Centre we specialise in ‘natural-looking results’, common areas for filler enhancement include the cheeks, chin & jawline, nasolabial folds (laughter lines), eye area, the nose, and lip enhancement.

When will I see the results from lower eyelid fillers?

You can expect to see relatively ‘instant results’ with our filler treatments. There will be minor swelling after the treatment, but for most patients that will resolve overnighT. More rarely there can be mild swelling for 5-days (in approximately 5%). There is a small possibility, <2% of a minor bruise, this will resolve over a few days. We use the latest technology to enhance recovery such as ‘no-needle” cannula techniques that enhance recovery. For most patients, the final results of cheek fillers will be evident approximately 5-days after the swelling subsides. With our techniques (application of filler at deeper levels) and filler choice will last 18 – 24 months, although results may vary from patient to patient.


Patient 1: “Tear trough filler can be completed to reduce hollowing and a shadow beneath the eyelid in younger patients with mild to moderate changes. The technique is important as with our use of a No-Needle Cannula technique, this speeds up recovery as 95% of patients have no bruising.”

Will I look natural with lower eyelid fillers?

Here at The Harley Street Face Clinic, we only specialise in natural-looking results. We believe in a natural augmentation of the lip area. Our aestheticians have pioneered research in the area of facial beauty and this has been published in the mainstream media and has been featured on multiple TV channels. We have also developed the application of the Phi Golden Ratio (used in many of the most famous Renaissance paintings of Leonardo Da Vinci) to the human face and we have multiple trained specialists that apply the principles of this facial balance and beautification technique. At The Centre, we have treated many celebrities and A-listers with these techniques to enhance natural beauty, a term we describe as beautification of the face, enhancing the natural Phi Golden Ratio Lines. Of key importance with filler, rejuvenation is avoiding excessive filler use as this no longer looks natural or beautiful. The key application of filler in specific areas of the face differs depending on each individual’s facial characteristics. The application of eyelid filler is different in masculine and feminine faces. In women, it is focused along the Phi Golden Ratio lines of the eyes, in men, it focuses along the lines of the chin and jawline. If you have already had a treatment that has been excessive it may be necessary to dissolve the existing filler or wait for the filler to resolve.

Will I experience any discomfort or pain?

We use a combination of treatments to minimise discomfort, these include the use of a powerful numbing local anaesthetic cream that is specially made for The Centre. We use a state-of-the-art Cannula (no needle) technique to minimise discomfort. We use fillers that have incorporated anaesthetic into the injectable fillers to increase patient comfort. At The Centre, we use additional numbing and vibration devises that use the Nobel Prize-winning research on ‘The Gate Control Theory of Pain” to minimise discomfort. At The Centre, we take the above measures to ensure most patients only experience minor discomfort.

Are there any risks or complications?

Studies on the safety of fillers have reported filler treatments as relatively safe with few side effects when completed by trained specialists. Recorded adverse events are usually minor including temporary injection site redness for less than three days. Patients may occasionally report temporary symptoms of redness, swelling, discomfort, lumps-bumpy changes, bruising, itching or change in colour. Infection is very rare however it is important that the treatment is completed in a CQC registered site (Care Quality Commission) and sterile precautions when having filler treatments. At The Centre all treatments are completed in our specialist Facial Centre on Harley Street. Serious side effects such as damage to the skin (termed Necrosis) or damage to vision have very rarely been reported. Our staff has pioneered the teaching of other doctors to avoid these serious issues in both National and International Conferences since 2012. Fillers are currently lacking from regulation, which remains a controversy in the UK. Precautions can be taken with competent practitioners to avoid these serious complications.


Patient 1: “A hyaluronic acid filler can be effectively used to rejuvenate the lower eyelid area. Care is required to use a filler with non-absorbable qualities (termed ‘Hydrophilic”) this is key to avoiding swelling after treatment”

What Filler treatments are best avoided in the lower eyelids?

We use a combination of treatments to focus on a natural rejuvenation that is both safe, long-lasting and safe. Over the last 5-years fillers have become more and more popular as both the product has reached new levels of quality and safety and our techniques and skills at using them have matured with experience, Our team have been using non-surgical treatments for patients for over ten years. We believe that it is important to avoid potential issues, we believe that there are certain products that are associated with higher risk issues, including permanent and semi-permanent fillers. In some patients this can result in long-term issues.

The lower eyelid is an intricate area of the face, and certain fillers should be avoided as they have properties that may result in increased swelling as well as lumpy-bumpiness all of which can be avoided. At The Centre we specialist in the face with the knowledge of these fillers that are best avoided (including Juvaderm).

Some patients may have facial anatomy which is characterised by marked changes of their lower eyelids and these patients are better suited to a surgical correction including the use of lower blepharoplasty with fat transfer.

How long does tear trough filler last?

How long the results from your tear trough treatment using dermal fillers will last will mostly depend your own individual response to the product. For tear troughs, a very fluid dermal filler is used, so as not to compromise the delicate skin tissues of the under eye area. Here at The Harley Street Face Clinic, we only use clinically-proven and FDA approved dermal fillers, for a safe treatment and a natural look. Depending on how your body metabolises the dermal filler product, you can expect results to last between 3 and 9 months. If you smoke, exercise excessively or frequently sunbathe excessively, the product will not last as long.

What do dermal fillers for the tear troughs do?

Dermal fillers for the tear troughs help to fill out any hollow areas under the eyes. This can help with eye bags as well as the appearance of dark circles under the eyes. They do not contain cross linking agents and are not thick and heavy, like some dermal fillers for other areas of the face. They are usually injected in to this area using a cannula, as opposed to a needle. A cannula will minimise the risk of bruising and is safer for this very delicate and vascular area. Dermal fillers will not minimise puffiness under the eyes, rather they can disguise the hollow areas under these bags and give the appearance of a lighter skin tone under the eyes.

How long do dermal fillers for the tear troughs take to work?

Results are seen straight away as the dermal filler will fill the lines under the eyes and lift up the skin tissues. There may be a little swelling immediately after your treatment which will settle in around 24 hours. The skin under the eyes is incredibly delicate and any injectable treatment might cause some trauma to this area, but any swelling is completely normal and will subside. As dermal fillers for the tear troughs are very fluid and not viscous, the recovery time will be fairly quick.

How often do you need to get a tear trough treatment using dermal fillers?

The longevity of your results somewhat depends on your individual response to dermal fillers and how quickly your body will metabolise the product injected. Some lifestyle factors such as smoking, excessive sun exposure and regular strenuous exercise can impede the longevity of your results and compromise the quality of your skin. At The Harley Street Face Clinic, we use products that are proven to provide the highest safety records as well as exceptional performance. Most patients will experience results for at least 3 to 6 months.

Is there any downtime or aftercare required with a tear trough treatment using dermal fillers?

You may have a little swelling, some tenderness and slight bruising following your tear trough treatment. However, this will ease in a day or so and will not prevent you undertaking your normal everyday activities. Aftercare will include avoiding saunas, hot baths, steam or excessive exercise for 24 hours post-procedure, as well as avoiding rubbing or touching the area for at least 48 hours. You may wish to rest on the day of your procedure and will be advised to avoid wearing any makeup for at least 6 hours post procedure.

What, if any, are the possible side effects of tear trough fillers?

On rare occasions there can be a serious issue with fillers around the eyes, resulting in damage to vision. For this reason it is important to see a specialist who has knowledge of the underlying anatomy of the face and how to avoid these issues. At The Harley Street Face Clinic, our practitioners are medically qualified to administer the treatment safely, there are multiple important steps that are necessary to ensure a good result free of issues (including cannula technique, procedure for injection, filler type). For some patients there maybe some slight swelling, bruising and tenderness may be experienced for 24 to 48 hours after your dermal filler treatment, but this is very normal and can be treated with ice and arnica gel to speed up the healing process.

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