What happens if tear trough hollows is not treated?

A tear trough is a groove between the lower eyelid and upper cheek. Shadowing in this area can make [Dark Circles](/symptoms/dark-circles/) appear stronger, even when the skin colour itself has not changed. Some people also have [Under-Eye Bags](/symptoms/under-eye-bags/) or reduced cheek support, which can deepen the transition between eyelid and cheek.

Leaving a hollow untreated does not damage the eye or create a medical emergency in itself. Its appearance may stay stable, or become more noticeable as skin laxity, facial structure, and [Facial Volume Loss](/symptoms/facial-volume-loss/) evolve. A new one-sided change, pain, swelling, or vision symptom needs a medical assessment rather than cosmetic treatment.

Begin with an in-person assessment that distinguishes a hollow from pigment, puffiness, thin skin, or a lower-eyelid pouch. Daily sun protection and gentle skincare can support the surrounding skin, but they do not replace lost contour volume. Depending on anatomy and goals, a qualified clinician may discuss [Under-Eye Filler](/treatments/injectables/tear-trough-filler/), [Eyelid Surgery](/treatments/surgical-dermatology/blepharoplasty/), or [Fat Transfer](/treatments/surgical-dermatology/fat-grafting/). Each has different suitability, recovery, and risk considerations.

Arrange medical review for sudden hollowing, marked asymmetry, persistent swelling, redness, tenderness, a lump, double vision, reduced vision, or difficulty moving the eye. After any procedure, urgent assessment is needed for severe pain, visual change, rapidly increasing swelling, or unusual skin colour. These signs are not explained by an ordinary stable tear trough.

Ask what is creating the shadow, whether cheek structure or eyelid bags are contributing, which options fit your anatomy, and what recovery involves. Also ask how risks around the eye will be managed and what result is realistic without overfilling the area.