Why Tear Trough (Under-Eye) Filler Often Goes Wrong – And How to Get It Right

The under-eye area is one of the first places we show signs of tiredness and ageing. Hollowness, dark circles and fine lines can make us look tired even when we’ve had a great night’s sleep!

That’s why under-eye filler has become a go-to treatment for so many people looking to improve these first signs of the ageing process.

But here’s the problem: Tear trough filler is one of the most mishandled aesthetic treatments. When done poorly, it can leave patients with lumps, swelling, puffiness, or even worsen the concerns they hoped to fix in the first place.

So why does it go wrong so often? And more importantly: how can you avoid it?

Let’s break it down.

What Is Tear Trough Filler?

Tear trough filler involves carefully injecting a hyaluronic acid (HA) dermal filler under the eyes to reduce the appearance of:

• Hollowness

• Dark shadows (caused by volume loss, not pigmentation)

• Fine lines or mild crepey skin

The goal is to subtly fill the groove between the lower eyelid and the upper cheek, creating a smoother, more youthful transition.

Why Does Tear Trough Filler Go Wrong?

Although it seems like a simple fix, the tear trough is a complex and delicate area to treat. Several factors can contribute to poor results:

Poor Patient Selection

This is arguably the biggest issue. Not everyone is suitable for tear trough filler. If the wrong patients are treated, complications and disappointing results are almost guaranteed.

Unsuitable candidates include those with:

• Significant under-eye puffiness or fat pads: Filler won’t improve this – it can actually make it look worse by adding volume where it’s not needed.

• Very thin or crepey skin: Filler can be visible through thin skin, causing lumps or a bluish tint.

• Prominent pigmentation: If your dark circles are caused by skin pigmentation rather than shadowing, filler won’t fix this.

• Chronic under-eye swelling: Certain people naturally retain fluid under the eyes — filler can exacerbate this.

A thorough, honest consultation is essential to assess whether filler is the right treatment, or if other options like skin boosters or topical treatments would be better.

Wrong Type of Filler

Not all dermal fillers are created equal. The under-eye area requires a soft, lightweight, and smooth-consistency filler, specifically designed for superficial areas.

Using the wrong product can result in:

• Swelling and puffiness

• Lumps and irregularities

• The ‘Tyndall effect’ (a bluish tint under the skin when filler is placed too superficially)

At Dove Aesthetics, we only use products clinically proven to be safe and effective for tear troughs, ensuring seamless, natural results.

Poor Technique

Even with the right patient and product, poor technique can lead to disappointing outcomes.

Common mistakes include:

• Injecting too superficially

• Using too much product

• Uneven placement

• Choosing a needle when a cannula would be safer and reduce bruising

An experienced, medically qualified injector will use precise, advanced techniques and adjust their method based on your unique anatomy.

Overfilling the Area

Less is more when it comes to under-eye filler. Even a tiny amount too much can cause:

• A puffy or heavy look

• Obvious bulging under the eyes

• Distortion of natural facial proportions

A skilled practitioner will often start with a conservative amount, allow it to settle, then top up if necessary, rather than overfilling in a single session.

Common Tear Trough Filler Myths

Let’s clear up a few misconceptions:

“It’s an easy, beginner-level treatment.”

Absolutely not – it’s one of the most advanced filler areas and requires detailed anatomical knowledge.

“Any filler brand will work.”

Incorrect – tear troughs need specific fillers with low hydrophilicity (less water-attraction) to avoid swelling.

“It lasts forever.”

No – results typically last 9–12 months but can vary based on metabolism, product choice, and technique.

Can Bad Tear Trough Filler Be Fixed?

Yes – thankfully, poorly placed or unsuitable filler can often be corrected.

Options include:

• Hyaluronidase (filler dissolving enzyme): Safely dissolves hyaluronic acid-based fillers, allowing the area to return to normal or be retreated properly.

• Alternative treatments: Skin boosters, microneedling or topical brightening treatments may be recommended instead.

It is common for many women to be turned down for treatment of tear trough at Dove Aesthetics, if it isn’t going to improve you or if it will potentially distort you; we will not carry this treatment out. Commonly women will attend thinking they require under eye filler but they will be best served having polynucleotide treatment or cheek filler treatment. This will be discussed in your consultation.

In Summary

Tear trough filler can be a brilliant, confidence-boosting treatment when performed by an experienced, medically qualified practitioner using the right product and technique – and on the right candidate.

Interested in a professional face assessment?

Book a consultation at Dove Aesthetics or get in touch today to find out how we can help you safely refresh your under-eye area.