Tear Trough Dermal Fillers: What are they and how do they work?

You can book a consultation with us at VIVA for free online or by calling 02037332199. We're open Monday to Saturday and typically have appointments available within a few days.

Every treatment starts with a face-to-face assessment rather than a booking straight into the chair. Tear troughs don't suit everyone, and part of the consultation is checking whether filler will actually give you the result you want or whether something else would serve you better.

If you're looking elsewhere, choose a practitioner registered with the GMC, GDC, NMC or GPhC, and check whether they appear on a voluntary register such as Save Face or the JCCP. Ask what product they use, whether they inject with a needle or cannula, and whether they keep hyaluronidase on site to dissolve filler in an emergency. Any good injector will be glad to answer.

Most people see results lasting nine to twelve months, though this varies. The under-eye area moves very little compared with the lips or around the mouth, so filler here tends to break down more slowly than elsewhere on the face.

You'll notice a difference straight away, but the final result settles at around two to four weeks once any swelling has resolved. Your metabolism, the product used and how much was placed all affect longevity younger people and those who exercise heavily often find filler metabolises a little faster.

When it does fade, it does so gradually rather than disappearing overnight. Many people choose to top up annually.

Most side effects are mild and short-lived. Expect some swelling, bruising and tenderness, which typically settle within three to seven days. Small lumps or unevenness in the first couple of weeks are common and usually resolve as the product settles.

Less commonly, some people experience prolonged puffiness, filler that migrates slightly, or the Tyndall effect - a faint bluish-grey tinge that can appear if product is placed too close to the surface. Both can be corrected.

Serious complications are rare but real. The most significant is vascular occlusion, where filler blocks or compresses a blood vessel. Because of the vessels around the eye, this carries a very small risk of visual problems. It's the main reason under-eye filler should only be performed by an experienced, medically qualified injector who can recognise and treat it immediately.

Filler is reversible. It can be dissolved with an enzyme called hyaluronidase, which we keep on site as standard. We'll go through all of this properly at your consultation before you consent.

Done well, no. The aim isn't to change how you look but to soften the shadow that makes you look tired. People tend to say you seem well-rested or ask if you've been on holiday, rather than spotting a treatment.

There's no bandaging or obvious sign afterwards. You can wear makeup from the next day, and most people return to work immediately. The main giveaway in the first few days is swelling or the occasional bruise, so if you have a wedding, holiday or big presentation coming up, book at least two to three weeks beforehand.

Filler is only obvious when too much is used or it's placed poorly. We treat this area conservatively and would rather bring you back for a small top-up than overfill at the first appointment.