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Some people look tired no matter how much sleep they get. Concealer settles into the crease by mid-morning, photographs exaggerate the shadow, and no eye cream seems to shift it.
Very often this has nothing to do with rest. It comes down to a natural hollow beneath the eye called the tear trough, and as it deepens, it casts a shadow that everyone reads as fatigue.
Tear trough filler is a non-surgical treatment that addresses the cause rather than covering it. At VIVA Skin Clinics we have been performing tear trough filler in London for over 12 years, across our clinics in Chelsea and Fitzrovia.
In this guide we cover what the tear trough is, how tear trough filler works, what it can and cannot improve, how long results last, what a treatment involves, and how to choose a practitioner in London.
The tear trough is the hollow that runs from the side of the nose, curving beneath the eye and above the upper cheekbone, creating a visible dip in the face under the eyes. It sits in the same region where eye bags, fine lines and wrinkles tend to appear.
The tissue here is exceptionally thin and delicate, thinner than anywhere else on the face, which makes it one of the first areas to show signs of ageing.
Tear troughs develop as we age and lose fat in the mid-cheek and under-eye area, leaving the hollow looking sunken. The result is a tired, older and less lifted appearance.
For some people, tear troughs are simply genetic and visible from their twenties. In either case the concern often worsens over time, as the skin beneath the eye thins and the blood vessels underneath become more visible through it. This is one reason the area can look dark as well as hollow.
These two concerns are frequently confused, and the distinction matters.
A tear trough is a depression, a loss of volume. It responds well to filler.
An eye bag is a protrusion, where fat pads push forward through the lower lid. Filler does not remove a bag. In some cases, where a bag looks more prominent because of the hollow sitting directly beneath it, smoothing that hollow can make the bag far less noticeable. But if the bag is the primary issue, a surgical option such as lower blepharoplasty is usually the more appropriate route, and we will say so at consultation.
Tear trough filler is well suited to:
It is often combined with cheek filler, which lifts and supports the mid-face and gives the under-eye a stable foundation to sit on. Treating both together frequently produces a more natural, balanced result than treating the under-eye in isolation.
You are likely to be well suited if you have genuine hollowing beneath the eyes, reasonable skin quality and elasticity, are in good general health, and have realistic expectations of a subtle, refreshing change rather than a transformation.
Tear trough filler is less suitable for those with prominent fat pads or significant eye bags, malar festoons or chronic fluid retention, very thin or lax under-eye skin, active infection in the area, or thyroid eye conditions.
It is not available during pregnancy or breastfeeding. It is also illegal in England to administer dermal filler for cosmetic purposes to anyone under 18.
Under-eye filler is a high-risk area, and any clinic offering the treatment should advise on patient risk and safety.
Common and temporary: Swelling, bruising and tenderness, typically settling within three to seven days. Small lumps or slight unevenness in the first fortnight are common and usually resolve as the product settles.
Less common: Prolonged puffiness, slight migration of product, or the Tyndall effect, a faint bluish-grey tinge that can occur if filler is placed too superficially. Both can be corrected.
Rare but serious: Infection, and vascular occlusion, where filler blocks or compresses a blood vessel. Because of the vascular anatomy around the eye, this carries a very small risk of visual complications. It is the single most important reason to choose an experienced, medically qualified injector for this area.
Dermal Fillers are non permanent and It can be dissolved using an enzyme called hyaluronidase, which we keep on site as standard, alongside a documented complications protocol. You can read more about tear trough filler safety here.
Wherever you go, these are the questions worth asking:
Any competent injector will welcome these questions. Be cautious of clinics offering unusually low prices, time-limited discounts or same-day treatment without a proper consultation. The under-eye is not the place to shop on price.
We are specialists when it comes to tear trough treatment, with two London locations.
Our Chelsea clinic on the King’s Road spans two storeys of clinical rooms, with a bright, light-filled reception and a separate private waiting room designed to feel calm and unhurried. Finished in the classic VIVA palette of natural, earthy, neutral tones, it sits within walking distance of Chelsea landmarks including The Bluebird Café and Megan’s.
Our Fitzrovia clinic is at 18 Cleveland Street, a five-minute walk from Tottenham Court Road. With both the Elizabeth line and Central line on the doorstep, it is our most convenient location for patients travelling in from across London and the South East.
Our London clinical team is made up of medical professionals delivering safe, ethical treatments with natural-looking results. Tear trough treatment is carried out exclusively by our cosmetic doctors and nurses, who bring more than 20 years of combined injecting experience to this area.
Our approach to the under-eye is deliberately conservative. We assess suitability before treating, select a product suited to the delicacy of the area, and place small volumes with precision. We would rather bring you back for a small top-up than overfill at a first appointment.
Choose between our experienced nurse practitioners and doctors. All treatments include a consultation and aftercare.
While your dedicated practitioner will always be there to answer every last one of your questions in person, this section is here to give you a bit of a head start on some of our most common queries.
Tear trough filler treatment can range from £299 to £650. At VIVA ours ranges from £375-£425 depending on the practioner.
If your dark circles are caused by shadowing from a hollow, you should see a clear improvement. If they are caused by pigmentation or visible blood vessels, filler will help less, and we would recommend a different approach. We will assess which type you have at consultation.
Yes. Hyaluronic acid filler can be dissolved with hyaluronidase, which we keep on site.
Results are immediate although vary in effect.
We advise waiting 4 weeks for a review to inject more into the area to ensure safety and prevent over filling the area.
Actual patient results from our clinic. Every treatment is tailored for a natural, balanced enhancement.


Dr. Rupert
We have three clinics accross London and the South of England. For contact details and assistance with parking or locating our clinics please call our friendly team at 02037332199
558 Kings Road SW6 2DZ London
18 Cleveland Street W1T4HZ London
38 High Street Tunbridge Wells Kent TN1 1XF
We offer free consultations and the below serivces at all of our clinic locations.
We have two convenient locations in London and one in Kent located in beautiful Tunbridge Wells. Click below to find your nearest VIVA!
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