Tear trough filler in Wiesbaden — gently evening out dark circles

What the tear trough is — and what else dark circles can be

Under the eye the skin is thinner than anywhere else on the face, and beneath it lies only a little fat. A band between skin and bone, the so-called tear-trough ligament, holds the tissue in place while the adjacent cheek loses volume and sinks over the years. This creates a hollow groove that casts a shadow in light from above — the classic “sunken” dark circle. This form can be well compensated with hyaluronic acid. But dark circles do not always have this cause: bluish-violet shadows from vessels showing through or brown discolouration from pigment do not improve with a filler, and sometimes become more noticeable. Telling these apart is the first and most important step of the consultation.

Who the treatment is suitable for — and who it is not

You have good preconditions if the trough is clearly defined, the skin is thin but not loose, and the tissue beneath the eye sits firmly. Filler injection is less suitable or not suitable in the following situations:

• Pronounced bags under the eyes — if fat bulges forward under the eye, a filler fills the hollow next to it and makes the bulge more visible. Here a surgical assessment is more appropriate.
• Tendency to swelling — anyone who regularly has swollen lower eyelids in the morning, allergies or so-called malar mounds (swellings over the cheekbone) will retain additional water with hyaluronic acid. The result then looks puffy rather than fresh.
• Very loose, crepey skin — a filler shows through beneath it; here, procedures that improve skin quality are more helpful.
• Dark circles caused by pigment or blood vessels without a hollow — see alternatives below.

If we advise you against tear trough filler, it is not a sign of uncertainty but part of the medical responsibility in this zone. There is often a better way.

Product and technique: soft, deep, little

Beneath the eye, only a soft hyaluronic acid with low water-binding capacity is used, developed specifically for areas of thin skin. It is introduced with a blunt cannula via a single entry point at the side and deposited deep, directly on the bony rim, in very small portions — usually 0.3 to 0.5 millilitres per side. The cannula spares vessels and lowers the risk of bruising; the deep placement prevents the material from showing through the skin. In many cases, the treatment begins one level lower: if the descended cheek is supported first, the tear trough shortens by itself and less is needed beneath the eye. How we contour the midface can be read under Jawline, chin and cheeks.

How the treatment works

Risks — particularly important in this zone

Swelling and bruising are more common beneath the eye and sometimes last longer than in other regions. Specific to the tear trough is the Tyndall effect: if hyaluronic acid sits too superficially, it can show through the thin skin with a bluish tinge. Irregularities, a bulging contour with too much material or downward migration of the filler are also possible. All of this can be corrected with Hylase — the enzyme dissolves hyaluronic acid so that the area can then be reassessed. Very rarely, filler enters a vessel; because the blood supply beneath the eye is connected to that of the eye itself, immediate medical action is taken in this case. We do not treat during pregnancy and breastfeeding, or in the presence of infection or herpes on the face. Guidance for the days afterwards can be found in the Aftercare for filler.

Preparation and timing

Because swelling and bruising under the eye are more noticeable than elsewhere, a little preparation is worthwhile. Plan the treatment at least three weeks before important occasions. You should not stop blood-thinning medication without consulting your doctor, but do tell us about it; it is best to avoid alcohol and high-dose omega-3 supplements in the days beforehand. If you suffer from hay fever, choose a period outside the pollen season so that allergic swelling does not distort the result. After the treatment, for a few days: do not rub, do not sleep on your face, no sauna, no intensive sport — and do not skip the follow-up, even if you are happy with the result.

Price and longevity

Tear trough filler starts at €450 for both sides — incl. 19 % VAT, billed according to the German medical fee schedule (GOÄ). The higher starting price compared with other zones is explained by the special product, the cannula technique and the time required for assessment and follow-up. Because the region is hardly moved, the result often lasts twelve months and longer. A consultation without treatment is possible at any time if you would first like to have your suitability assessed.

Alternatives when hyaluronic acid is not suitable

• Skin booster — non-cross-linked hyaluronic acid for moisture and firmness of the thin skin under the eye, without volume; sensible for crinkled skin. More under skin boosters in Wiesbaden.
• Meso Eye — a mesotherapy specifically for the eye region, targeting circulation, lymphatic drainage and skin quality; an option for a tendency to puffiness and vascular shadows. See Meso Eye treatment.
• Cheek augmentation instead of tear trough — if the midface is supported, the hollow often becomes shallower without any injection under the eye. All zones at a glance on the main page hyaluronic acid fillers in Wiesbaden.

Related pages

• Hyaluronic acid fillers in Wiesbaden — overview
• Nasolabial fold filler
• Contouring jawline, chin & cheeks
• Lip augmentation
• Skin booster
• Hyaluronidase (Hylase) — dissolving filler
• Hyaluronic acid for Mainz
• Hyaluronic acid fillers for Frankfurt
• Guide: What does hyaluronic acid filler cost?
• Guide: How long does hyaluronic acid filler last?
• Guide: side effects and risks
• Guide: Hyaluronic acid filler or skin booster?
• Aftercare after filler

Read more in the guide

• Hyaluronic acid: side effects and risks honestly explained
• Dissolving filler — when hyaluronidase makes sense
• How long does hyaluronic acid last?

Frequently asked questions