What is tear trough filler? We spoke to three Australian skin specialists who perform the procedure to give you answers.
Tear trough filler treatment is used to correct volume loss under the eyes. “As we age, we lose some of the fat pads that surround the face,” explains Dr Josh Wall, a cosmetic physician who performs the procedure 10-20 times per week at Contour Clinics in Sydney.
A filler – most often a concentrated version of the natural sugar hyaluronic acid – is injected below the eye with a fine needle or cannula. “The tear trough is the area under the eye where people often say, ‘I look tired’, or ‘I’ve got dark circles’,” says Dr Joanna Teh, a cosmetic doctor who works at Dermedica Perth Cosmetic Clinic – she’s been performing the procedure for nearly 20 years.
“What happens is, with the filler, we go under the trough, which is the dip that they see makes a shadow,” she says. “When the filler is placed under the trough, it lifts the skin to [be] level. It removes the shadowing, so then they don’t look as tired,” says Dr Teh.
Dr Hope Dinh, a dermatologist operating at Hope Dermatology in South Melbourne, says tear trough filler “can have a significant rejuvenating effect, making a person appear well-rested, fresh and more youthful.” A big drawcard for this treatment is that results are instant.
Is it painful to have it done?
You can use a numbing cream before the injection. Dr Dinh says that “the product itself already contains a small amount of a local anaesthetic.” But after watching plenty of videos of the treatment and reading reviews, I’d say that there can be significant discomfort involved.
Is it popular?
Very. All three skin specialists agreed it was a popular treatment. They often had clients who were sick of being told they look tired.
How long does it last?
Depending on a variety of factors, from your metabolism to the type of product used, it can last between nine and twelve months. “It depends on the individual,” says Dr Wall. “If you’re an ultra-marathon runner, then it’ll probably last three months. Where if you exercise like a regular person then it’ll probably last closer to twelve.”
Asked why that is, he continues, “Well, if you are incredibly fit, your body is just extremely efficient at processing things. So your body will eventually just metabolise the product over time.”
What are the costs?
It depends from clinic to clinic. At Dermedica, prices start at around $500. At Contour Clinic, it’s $650 per ml, and Dr Wall says about 90 per cent of patients need one ml.
What are the dangers of tear trough filler?
Bruising, black eyes, swelling and infection are all risks, but usually swelling will go down after a few days. There’s the Tyndall effect, which happens when filler is placed incorrectly in the skin, leading to a blue or grey tinge.
“It’s actually quite a risky area,” says Dr Teh. ABC‘s Four Corners recently reported that a woman was taken to hospital after having her face injected with fillers, and went permanently blind in one eye.
“Filler is a solid substance, which we are injecting into highly vascular tissue,” says Dr Dinh. “If filler is inadvertently injected into an artery, which supplies oxygenated blood to the tissue, then it blocks that tissues supply of oxygen.” If gone undiagnosed, this can lead to tissue death, and in severe cases, blindness.
“It’s important that patients are educated in all risks and potential complications that can occur with any treatment in order to obtain informed consent,” continues Dr Dinh.
There are steps you can take to make sure you receive the best care possible. “You’d have to win the unlucky lottery… multiple times over,” says Dr Wall of experiencing blindness post-op. “The thing is, there have been two cases in Australia that have happened in quick succession, and one was [by] someone who was poorly supervised by her surgeon, and didn’t have the reversal agent, which is criminal. And they didn’t even know how to use it. So that’s why it’s important to go to a clinic that is established and professional and that have protocols in place.”
Ask your dermatologist if they have the ACE guideline protocol on hand for a reversal treatment, a guide written by an expert group in the UK. If in the rare event something went wrong, you’d be under time pressure – reversal needs to happen within four hours.
Is tear trough filler right for you?
The tear trough filler isn’t a fix-all solution to hollow eyes. Lack of sleep, hyperpigmentation and sinus infections can all impact the tear trough, and can be treated through other (likely safer) means.
“There’s a lot of patients that can’t have this treatment done,” says Dr Wall. “They have fat prolapsing, the pathology of their tired look is not conducive to tear trough filler. So probably the most important thing in this area is having a clinician who understands who is suitable and who is not suitable for this treatment.” Wall uses a collaborative, educational process when determining the best treatment for patients.
What should you look for when picking a clinic?
“With this particular procedure, you need to find a clinic that has advanced, experienced injectors. Personally, being a doctor, I would try to find an experienced doctor,” says Dr Teh. Dermatologists are trained as doctors, going to university for a minimum of six years before receiving another four of specialist training.
“Make sure that they monitor your skin afterwards,” says Dr Teh. She says the doctor should keep in contact with you over the next few days and should be available on-site. “If an emergency happens, you want someone to be there,” she adds.
“It’s quite a simple procedure in the right hands,” says Dr Wall. “You should go to someone who does lots and lots of them.” Dr Dinh adds, “[They should have] your best interest at heart and [should not be] profit-driven, literally pumping out filler.”
Reviews
Sarah Bridget reviewed the treatment, saying, “I can tell that I don’t look as tired. There’s still some indentation. It didn’t erase [my under eye bags] completely by any means, but at the same time I do feel like it’s lifted quite a lot.”
Make-up artist Jaleesa Jaikaran reviews the procedure in-depth, and says, ‘I’m very happy when I smile [that] I don’t have that deep puff that I would usually have. I don’t think I’m going to do anything else, but I will probably do a follow up.”
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