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We treat pronounced tear troughs to help the eye area look less tired and more refreshed.
A pronounced tear trough can cast a shadow between the lower eyelid and cheek, making the eyes look tired. When volume loss is the cause and filler treatment is suitable, small amounts of hyaluronic acid can soften this transition. We first assess what is creating the dark or uneven appearance around the eyes, because pigmentation, visible blood vessels, swelling and hollows require different approaches.
Tear trough correction replaces missing volume at the transition between the lower eyelid and cheek. This can reduce the shadow caused by a hollow. Filler itself does not remove existing pigmentation.
The skin beneath the eyes is thin, so even small irregularities can be noticeable. Hyaluronic acid also attracts water. For this reason, careful product selection, limited amounts and precise placement are especially important in this area.
Our aim is to create a softer transition without making the under-eye area look puffy. We use carefully limited amounts and reassess the result once swelling has settled before deciding whether any further treatment is appropriate.
Treatment may be suitable when a genuine hollow beneath the eyes creates a pronounced transition to the cheek and the tissue structure is suitable for volume replacement.
If there are prominent under-eye bags, recurring lower-eyelid swelling or significant skin laxity, we assess particularly carefully whether filler is appropriate. Additional material can worsen existing fluid retention. If dark circles are mainly caused by pigmentation or visible blood vessels, we discuss other options.
We also take any existing filler into account. If swelling persists or the contours are irregular, we first investigate the cause before considering further treatment.
The eye area requires particularly careful planning. Serious complications are rare, but a vascular complication can cause tissue damage and permanent visual impairment, including loss of vision. Even correctly performed treatment cannot eliminate these risks completely.
If an unexpected change occurs, we arrange the necessary assessment and treatment and support you through the next steps.
Treatment is based on a careful assessment of the entire lower-eyelid and cheek area.
We assess the tear trough, skin thickness, eyelid contour and transition to the cheek. We look for swelling, prominent fat pads and existing filler. We also ask about previous eyelid surgery, eye conditions, allergies and recurring fluid retention. Together, we discuss what degree of improvement is realistically achievable.
We document the area before treatment and identify the areas to be treated. The skin is then cleansed and disinfected. Any anaesthesia is tailored to the delicate eye area and your individual needs.
A suitable hyaluronic acid gel is placed in small, controlled amounts using a needle or cannula. The technique depends on your anatomy and clinical findings. During treatment, we monitor the tissue response and contour. We do not aim to fill the hollow completely if this would be inappropriate.
After treatment, we examine the eye area and explain what to expect during recovery. Early swelling can conceal the result or temporarily make the area look fuller. Follow-up is planned individually, often after around two to four weeks. If you develop symptoms, we will assess you sooner.
Tell us about previous filler treatments, eyelid surgery, eye conditions and recurring swelling. Allergies, medications and relevant general medical conditions are also important for planning. If there is acute inflammation of the eyes, eyelids or surrounding skin, we postpone treatment. Please also tell us about any other current infections. Do not stop prescribed medication without medical advice.
At first, avoid rubbing, strong pressure and massaging the area beneath the eyes yourself. Clean the area gently and follow our advice on make-up and skincare. If needed, you can cool the area gently with a clean, wrapped cold compress without applying pressure. We will give you personalised advice about exercise, sauna use and significant heat exposure. Monitor whether swelling is settling or increasing, and let us know about any unusual changes. New changes in vision, unusual skin discolouration or unusual pain require immediate medical assessment.
A change in the transition to the cheek may be visible straight away. However, we assess the result only once the initial swelling has settled sufficiently. Under the eyes, this can take longer than in other areas of the face. How long the correction remains visible depends on your individual tissue response and how your body breaks down hyaluronic acid, as well as the product, amount and placement. Sleep, allergies and other personal factors can also change the appearance of the eye area without necessarily meaning that the filler has broken down. Before any top-up, we therefore examine the area carefully to confirm whether volume is genuinely lacking. As long as sufficient filler remains, we do not recommend an additional injection.
Download the key preparation and aftercare guidance as a PDF.
Before treatment, we discuss whether filler correction is suitable for your tear troughs, which product may be appropriate and how much treatment is needed.
Costs may vary depending on the product, amount required and agreed combination of treatments. We confirm the total price with you before treatment begins.
Answers to your questions about tear troughs, under-eye shadows and aftercare.
We replace missing volume at the transition between the lower eyelid and cheek. This can soften the shadow created by a hollow. Dark circles caused by pigmentation, visible vessels or swelling are not automatically corrected by filler, so we first establish the cause.
The appointment takes around 30–60 minutes. A change may be visible immediately, but swelling can make the early result difficult to judge. Follow-up is based on your individual recovery and is often planned after two to four weeks.
You may feel pressure or brief discomfort during treatment. Appropriate anaesthesia can be used if needed. Afterwards, swelling and bruising may occur and can be more visible beneath the thin under-eye skin. We discuss in advance how much time to allow before important events.
Treatment may be suitable when a true hollow is creating the shadow and there is no significant tendency to swell that would make filler unsuitable. Existing eye bags, previous filler and the condition of the skin are all considered in the decision.
Afterwards, treat the eye area gently and follow our care advice. We remain available if you have questions about your recovery. Changes in vision, unusual pain or unusual skin discolouration require immediate medical assessment.
Swelling and bruising can be particularly noticeable beneath the eyes. They may last for several days and occasionally longer. Recovery within one to three days therefore cannot be guaranteed. Allow enough time before important events.
Mild swelling, bruising and tenderness are possible temporary reactions. In this area, longer-lasting fluid retention, visible unevenness or a bluish discolouration from superficially placed material can also occur. Infection or inflammatory nodules are less common. If swelling persists, returns or increases, we investigate the cause. Please do not try to correct the area yourself with firm massage or additional treatments.
In some people, volume loss in the upper cheek contributes to the pronounced transition beneath the eye. In that situation, it may be sensible to support the cheek first and then reassess whether the tear trough itself still needs treatment. Depending on the cause of dark circles and the condition of your skin, treatment of the eye area may be combined with other procedures. These can include CO₂ laser, mesotherapy, skin boosters, polynucleotides, PRP and Juvelook as a collagen stimulator. Exosomes may also be discussed during a medical consultation as a possible complementary option; suitability depends on the specific product and intended use. Following a medical assessment, we decide which procedures are appropriate for you, the order in which they should be performed and how long to leave between them. A combination does not mean that all treatments are performed at the same time or directly in the tear trough. Treatments around the eyes require an appropriate indication and specific protective measures. We do not routinely recommend additional injections beneath the eyes, particularly if you are prone to swelling. If you have prominent under-eye bags or excess skin, other options may be more suitable, including surgery where appropriate. We will discuss these with you.
Under the eyes, choosing the right treatment is just as important as the injection itself. We therefore distinguish carefully between volume loss, pigmentation, skin changes and a tendency to swell.
If shadows or hollows beneath your eyes concern you, we first assess what is causing them. We explain whether hyaluronic acid is likely to improve the appearance or whether another treatment would be more suitable. You receive a realistic assessment and time to make your decision.
A 30-minute consultation costs €75.
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Specialist in anaesthesiology with a focus on aesthetic medicine and pain management.
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Specialist in ophthalmology with a focus on facial contouring and aesthetic eyelid treatments.
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Head of medical cosmetics and device-based aesthetic treatments, with a focus on skin analysis and personalised skincare.
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