What are the treatment options for tear trough hollows?

A tear trough is a groove between the lower eyelid and cheek. Shadowing can reflect a naturally deep groove, reduced soft-tissue volume, prominent lower-eye fat, thin skin, or a combination of these features. The right approach depends on what creates the shadow rather than on the hollow alone.

[Under-Eye Filler](/treatments/injectables/tear-trough-filler/) adds volume beneath the eye using an injectable product. [Fat Transfer](/treatments/surgical-dermatology/fat-grafting/) uses tissue collected from another body area. [Eyelid Surgery](/treatments/surgical-dermatology/blepharoplasty/) can address lower-eyelid fat or skin changes when surgery is more suitable.

A consultation should include an examination at rest and while smiling, review of allergies and previous injections, and discussion of swelling, bruising, asymmetry, and the visual effect of treatment. Filler is not appropriate for every under-eye shape, particularly when bags or fluid retention contribute strongly to the appearance.

Ask how the clinician would manage the transition between the lower eyelid and cheek, what recovery involves, and whether staged treatment is sensible. Bring a list of medicines and mention any history of eye disease or prior facial surgery.

Seek prompt medical assessment for a new hollow that appears suddenly, follows injury, or is associated with pain, marked swelling, redness, or vision change. After an injectable or procedure, urgent review is needed for severe pain, pale or mottled skin, worsening swelling, or any change in vision.

What is causing my under-eye shadow: a groove, fat, skin, or volume loss? Which option addresses that cause? What are the alternatives if filler is unsuitable? How long might swelling last? What warning signs require immediate contact?