If I were to name one major nemesis of a youthful, fresh look, it would be the tear trough.
This depression, which forms under the lower eyelid, is characterized by a sunken appearance under the eye that casts a dark shadow and gives the patient a tired, aged appearance. The tear trough is a particularly troublesome area because it can make one appear older, fatigued, or even unwell, even if they are in excellent health. It’s a feature that can be quite challenging to camouflage with makeup alone and often becomes more pronounced with age.
The fat around the eyes can shift forward into the lower eyelid region as the retaining ligaments in this area loosen. This leads to the "bags under the eyes" effect, which can be further exacerbated by the loss of volume in the cheek region. As the skin naturally loses its elasticity and the underlying structures change, the face starts to lose its youthful contour. Instead of smooth transitions between the cheek and under-eye area, there is a noticeable groove or hollow that causes the face to look sunken and tired.
Tear Trough Treatment with Dermal Fillers
There is also a loss of fullness due to fat changes that occur in and around the eyes, resulting in pronounced tear troughs. This can lead to an overall imbalance in facial harmony. The hollowed appearance often gets deeper with time, and this loss of volume can make even those who are otherwise youthful in appearance look significantly older than they feel. This, combined with the natural darkening of the skin under the eyes, can create a look of permanent fatigue.
As you may already know, dermal fillers are the best way to treat these particular aging issues. Fillers, particularly hyaluronic acid-based ones, can help restore the volume lost in the tear trough area, smooth out the under-eye region, and rejuvenate the overall facial appearance.
The primary function of the filler is to replace the lost volume and re-establish a smoother contour between the lower eyelid and the cheek. The results are often immediate, offering a more rested, youthful look without the need for surgery.
Effective But Comes with Risk
Puffiness under eyes is not so much the problem, but rather the groove underneath. Fillers can be used to smooth out the transition, so you do not see a break in the felt pads between the under-eye and the cheek itself. The subtle addition of dermal filler essentially fills the depressions, creating a more cohesive and youthful appearance. While the treatment does wonders for some individuals, it is essential to understand that, like any cosmetic procedure, under-eye filler treatments can go wrong if not performed correctly.
Botched Tear Trough Filler
A botched tear trough filler refers to a filler treatment that has gone wrong in the delicate and sensitive under-eye area, typically due to errors in the technique, incorrect product usage, or complications that arise during the procedure.
The tear trough is a challenging area to treat because of its thin skin, proximity to sensitive structures like blood vessels, and its anatomical complexity. Fillers are typically used to address issues such as under-eye hollows, dark circles, or mild to moderate under-eye bags, which are common signs of aging, genetics, or fatigue. The goal of a successful tear trough filler is to restore lost volume, smooth the transition between the under-eye area and the cheek, and improve the overall appearance of the face.
While tear trough fillers are generally considered safe when performed by a skilled and experienced injector, things can go wrong. When the procedure is not done correctly, a botched tear trough filler can lead to a series of complications ranging from minor aesthetic concerns to more serious medical issues. The delicate nature of the under-eye area makes it a particularly challenging region to treat, and a poorly performed procedure can cause noticeable, sometimes irreversible changes that not only look unnatural but may also lead to physical discomfort or even permanent damage.
What May Cause a Botched Tear Trough Filler?
There are many reasons why a tear trough filler treatment may go badly. Before jumping into those reasons, however, it's important to note that botched treatments are quite rare. Especially when you visit a professional clinic, your treatment should be quite safe. It's generally only with unlicensed or inexperienced medical aesthetic spas or providers that botched treatments come about.
Incorrect Injection Technique
The most significant cause of a botched tear trough filler is incorrect injection technique. The under-eye area is highly sensitive and requires precision. A skilled injector should understand the anatomy of the tear trough and be able to accurately place the filler at the correct depth and angle to avoid complications.
The filler must be injected beneath the skin’s surface, typically in the subdermal layer, to create a smooth, natural appearance. Injecting too superficially can result in visible lumps or bumps under the skin, while injecting too deeply can cause the filler to migrate to surrounding areas or create a lumpy, uneven texture. Improper placement of the filler can cause it to affect the muscles or blood vessels, leading to more serious complications like vascular occlusion.
Excessive Filler Use
Another common issue that can lead to a botched treatment is overfilling the area. It’s easy for injectors to be overly generous with filler, especially if they’re trying to completely “erase” the tear trough. However, this can result in excessive puffiness or a bulging effect under the eyes.
Instead of smoothing out the hollow, overfilling can create a puffy, swollen appearance that looks unnatural and sometimes even more tired or aged.
It doesn’t just stop there, as overfilling can disrupt the natural balance between the under-eye area and the cheeks, leading to a disproportionate look. It’s essential that fillers are used conservatively to maintain the natural contours of the face. The goal should always be a subtle, gradual enhancement rather than dramatic changes.
Wrong Type of Filler
There are different types of dermal fillers, each formulated with specific properties to suit different areas of the face. The wrong choice of filler can result in unnatural, hard-to-correct results. For example, if a thick, firm filler is used in the delicate under-eye region, it may not blend seamlessly with the soft tissues, causing an uneven, lumpy appearance.
On the other hand, a filler that is too soft or fluid may fail to provide the necessary structure in the tear trough, leading to a lack of volume restoration and ineffective results. A hyaluronic acid-based filler is often preferred for tear troughs because of its smooth consistency and ability to integrate well with the skin’s tissues. The choice of filler should always be made by a practitioner who understands which type will work best for the individual patient’s needs.
More on Use of the Wrong Filler
There are several different classes of dermal fillers used in aesthetic treatments, each serving distinct purposes depending on the area being treated. When it comes to delicate areas such as the under-eye or tear trough region, hyaluronic acid-based fillers are often the go-to option. Brands like Juvederm®, Restylane®, and Belotero® are the most commonly used for these treatments.
The reason hyaluronic acid (HA) fillers are preferred for the under-eye area is due to their ability to restore volume, smooth out the skin, and provide a natural-looking result. These fillers are typically versatile, safe, and, most importantly, can be dissolved if complications arise.
Hyaluronidase
The good news for anyone who is concerned about the possibility of poor results or complications from under-eye fillers is that hyaluronic acid-based fillers can be dissolved. This is achieved by injecting a substance called hyaluronidase, an enzyme that breaks down the hyaluronic acid in the filler.
Hyaluronidase works efficiently by accelerating the natural process of the body breaking down the filler, which allows the area to return to its previous state or be corrected in a way that is more aesthetically pleasing.
This ability to dissolve fillers provides an incredible safety net for both patients and practitioners. If a filler is causing a problem, such as affecting the blood flow or interfering with the appearance in an unintended way, hyaluronidase can reverse the effect quickly and safely.
In many cases, it’s not uncommon for patients to need a touch-up or correction after their initial filler treatment, especially if they have gone elsewhere for treatment and are unsatisfied with the results. For those who experience complications like uneven results, lumps, or excessive puffiness, dissolving the filler can be a fast and effective solution.
Fixing Disappointing Tear Trough Filler Results
Over the past year, I’ve found myself dissolving more and more poorly placed fillers for patients who come to me after disappointing treatments elsewhere. It’s always nothing short of a rewarding experience for me to offer a solution that works, as it allows me to restore utmost confidence in my patients. There’s a great sense of relief when I can take a patient who is unhappy with their results and provide them with a corrected, natural outcome.
Hyaluronidase truly is a game-changer for practitioners, as it not only provides a fail-safe but also allows us to give patients another chance at achieving their desired results without resorting to invasive procedures. For those who have experienced under-eye filler gone wrong, this can be a complete turnaround.
Not All Fillers can be Dissolved
That being said, not all dermal fillers come with the same flexibility. Hyaluronic acid fillers have the distinct advantage of being reversible, but other types of fillers, like Radiesse®, Sculptra®, and Artefill®, don’t have the same dissolution option.
These fillers are made of different substances and are designed for longer-lasting results, sometimes providing effects that can last from several months to a few years. While this might sound like an appealing option for some patients, the downside is that, once injected, these fillers cannot be reversed in the same way that hyaluronic acid fillers can. This makes any mistakes made during treatment much more difficult to correct.
We Advice Against Non-Hyaluronic Acid Fillers
When these non-hyaluronic acid fillers go wrong, patients often face a more complicated situation. For example, if the filler causes uneven results, excessive volume, or a change in facial contours, there’s no easy way to dissolve it and start fresh. In these cases, patients might have to consider more invasive surgical techniques to remove or adjust the filler.
This could involve incisions or even the use of liposuction to remove the filler from the area. Not only does this carry additional risks, but it also introduces recovery time and the potential for scarring, making it a more complicated and costly process than simply dissolving a filler with hyaluronidase.
Because of these potential complications, I strongly advise against using these permanent and partially permanent filler products in areas as sensitive and delicate as the eyelids or the tear troughs. The risk of lasting complications is simply not worth it.
The tear trough is already one of the most challenging areas to treat with fillers due to the complex anatomy, thin skin, and proximity to sensitive structures. Using a filler that cannot be easily dissolved in this region is a risk I believe is best avoided.
Patient DIY Fillers
It goes without saying, but you should NEVER buy injectables on the internet or try to inject them yourself. It’s come as quite the surprise that many people are tempted to try DIY cosmetic treatments at home, purchasing injectable fillers online with the intention of injecting them themselves.
I bring this up because when it comes to botched tear trough fillers, DIY projects are one of the main sources.
While it might seem like a cost-effective solution, attempting to inject fillers on your own is extremely risky and can lead to some disastrous consequences. The DIY injectable market has grown due to online platforms offering products at seemingly affordable prices, but the risks far outweigh the potential savings.
Unregulated and Unsafe
First and foremost, the injectables sold online are often unregulated, meaning they could be counterfeit, expired, or unsafe. These products might not even be intended for use in the delicate areas of your face, let alone injected into your under-eye region.
Injecting fillers also requires a deep understanding of facial anatomy, proper technique, and a steady hand - one that is honed in its practice. Injecting fillers is not a DIY job, and the consequences of getting it wrong can be long-lasting and damaging, not just physically but emotionally as well.
Unfortunately, more and more people are opting to perform these procedures themselves, thinking it’s as simple as watching a YouTube tutorial. This self-inflicted beauty trend is dangerous, and too often, it leads to the very thing people are trying to avoid: fillers gone wrong.
DIY Damage Can be Irreversible
These results can sometimes be irreversible, leaving people with lumps, uneven texture, puffiness, and worst of all, the need for surgical intervention to correct the issues. No one wants to spend time, money, and energy on a procedure that leaves them with the opposite effect of what they wanted, and DIY injectables almost always lead to disappointment.
Facial Anatomy
Keep in mind that not every face is suitable for under-eye fillers, and a reputable injection specialist will always take your unique facial anatomy into account before making any treatment recommendations.
If you’re thinking about getting under-eye fillers, it’s crucial to be assessed by a trained and certified professional. There are certain facial structures or conditions that may make under-eye fillers not ideal for you. For example, if you have thin skin, deep-set eyes, or pre-existing skin issues, fillers might not provide the results you’re hoping for, or in some cases, it could exacerbate the problem.
A skilled practitioner will assess your individual needs and make sure the procedure is appropriate for you. If they determine that under-eye fillers are not right for your anatomy, trust their professional opinion. It’s important to know that just because you want a treatment, doesn’t mean it’s the best course of action for you.
A responsible practitioner will never pressure you into a procedure if they believe it’s not in your best interest. Your health should always come first, and the last thing you want is to rush into a decision that you’ll regret later.
What Happens If an Under-Eye Filler Goes Wrong?
Let’s run through what can happen when under-eye filler procedures go awry and the complications that can arise as a result.
The Tyndall Effect
One of the more common and often frustrating complications associated with under-eye fillers is the Tyndall effect. This phenomenon occurs when the dermal filler is injected too close to the skin’s surface, causing light to scatter in an unnatural way beneath the skin.
The Tyndall effect manifests as a bluish or greyish hue that becomes visible under the skin, especially in the thin and translucent under-eye area. The effect can be highly noticeable, creating an undesirable and unnatural look. In some cases, this can even make the problem that the filler was intended to fix (like hollowing or dark circles) appear worse.
The key to preventing the Tyndall effect is ensuring that the filler is injected at the proper depth. It’s essential that the right type of filler is used for the under-eye area and that the product is placed deep enough in the tissue to avoid light scattering.
Formation of Nodules
Another complication that can occur with under-eye fillers is the development of nodules or small growths of skin tissue. Nodules can form for a variety of reasons, including improper technique or the use of a filler that isn’t suited for the sensitive under-eye region.
These lumps or bumps can appear shortly after the procedure and may be caused by filler that has not been evenly distributed or has clumped together under the skin. These nodules can be uncomfortable or unsightly, and in some cases, they may require further treatment to correct. In some instances, the nodules may dissolve on their own over time, but in other cases, additional interventions may be necessary to smooth the area out and restore a natural look.
Overfilling and Puffiness
The goal of under-eye filler treatments is typically to restore volume, smooth out hollows, and reduce the appearance of tiredness. However, if too much filler is used, it can result in increased puffiness under the eyes. Injecting too much product can create a puffy, swollen appearance under the eyes that may resemble bags or exaggerated under-eye puffiness. Instead of achieving a smooth transition from the under-eye area to the cheek, this overfilling can result in a more pronounced bulge that is both unnatural and difficult to correct.
Unfortunately, once the filler has been injected, the only way to correct this issue may be to dissolve some of the product, which is a time-consuming and costly process. To avoid overfilling, it’s crucial that an injector with a keen eye for balance and symmetry is performing the procedure.
Difficulty in Achieving a Natural Contour
The under-eye area is arguably one of the most challenging regions of the face to treat with fillers because it requires absolute perfect precision. The goal is to restore volume and smooth out the under-eye contour without disrupting the natural shape of the face.
If the filler is applied unevenly or too aggressively, it can result in an unnatural appearance where the transition from the cheek to the under-eye area looks harsh or misaligned. This can make the face appear uneven, aging the person rather than enhancing their features.
Achieving a smooth, seamless transition between these two areas requires a skilled injector who understands facial anatomy and knows how to work with delicate features.
Migration of Filler
A poorly executed tear trough filler can cause the product to migrate beyond the intended area. For instance, the filler might move downward toward the cheeks or upwards into the lower eyelids, creating an unnatural, bulbous appearance.
Migration can also cause the skin to look uneven, which is especially noticeable when the person smiles or moves their face. Migration can be difficult to correct and may require dissolving the filler or performing touch-up treatments to realign the product.
Vascular Occlusions
One of the more serious, albeit rare complications that can occur with under-eye filler is when the filler is inadvertently injected into a blood vessel. The areas around the eyes and forehead are filled with a dense network of blood vessels, which makes them more vulnerable to complications if the filler is improperly injected.
If the filler enters a blood vessel, it can cause the vessel to become blocked, leading to vascular occlusions. This can disrupt the blood flow to the area, causing a range of serious issues.
Tissue death (necrosis)
When blood flow to the skin is blocked due to a vascular occlusion, the tissue in the affected area can begin to die. This can lead to permanent scarring that is difficult to repair. Immediate intervention is crucial to avoid permanent damage if a vascular occlusion occurs.
Scarring
When blood flow is compromised and tissue damage occurs, it can result in scarring that affects the skin’s appearance and texture. Scarring can be difficult to treat, and it can lead to permanent texture changes in the skin.
Infection and inflammation
If the procedure is not done in a sterile environment, or if aftercare instructions are not followed correctly, bacteria can enter the injection site and cause an infection. Infections can lead to significant swelling, redness, and pain in the treated area. In some cases, an abscess may form.
This may require antibiotics or, in more severe cases, surgical drainage. Infections can also result in longer-term scarring or tissue damage, further complicating the recovery process.
Allergic reactions
Though rare, some individuals may have allergic reactions to materials in the filler. Common symptoms of an allergic response include redness, swelling, itching, or rash. An allergic reaction can make the treated area even more swollen and painful, and could potentially cause lasting discomfort or damage.
Blindness
In very rare cases, a vascular occlusion can cause complications that affect the eyes and vision, potentially leading to permanent vision loss.
Minimal Risk with Experienced Providers
Again, these complications are rare but they very well underscore the importance of choosing a qualified and experienced injector who understands facial anatomy and is able to avoid these dangerous outcomes. The risks associated with vascular occlusions merely highlight the need for a highly skilled practitioner who uses appropriate techniques and takes all necessary precautions to ensure the safety of the procedure.
If you find yourself experiencing unwanted side effects from a tear trough filler, the first step is to consult your practitioner immediately. A professional, experienced injector will be able to assess the situation and recommend possible corrective measures.
Unqualified Injectors
In the UK, the demand for non-surgical cosmetic treatments, like dermal fillers, has exploded in recent years. It's no wonder that quick, relatively painless procedures that promise visible results with minimal downtime have become increasingly popular. But here's the catch: While these injections can be transformative when performed correctly, there’s a growing number of practitioners offering subpar treatments that can leave patients with disappointing- or even dangerous results.
Advanced Filler Treatment
Tear trough filler injections are not your average filler treatment. The skin under the eyes is thin, delicate, and highly sensitive. It's also a complicated area anatomically, with numerous blood vessels, nerves, and muscle structures to consider. Getting it right requires a deep understanding of facial anatomy and a level of precision that's difficult to achieve without proper training.
While many injectors claim to have the skills to treat the tear trough area, the reality is that a large proportion of practitioners simply don’t have the expertise needed to navigate the complexities of this delicate region. And that’s where things can go horribly wrong.
Good Intentions, Poor Results
I have no doubt that many of these people only want the best when performing facial filler injections. But they do not have the expertise to really help their patients. Expert under eye filler requires a broad knowledge base as well as the ability to use a variety of facial rejuvenation instruments and techniques.
Many under eye filler providers take courses that are designed to teach the fundamentals. Those courses often fail, however, to provide a deeper understanding of the complex structures in and around the under-eye area. People without knowledge of facial anatomy can get inconsistent results leading to all these cases we read in the previous section of under-eye fillers gone wrong.
The truth is, expertise matters. This is especially true when it comes to a procedure as sensitive as tear trough fillers, and as serious as what a patient might see when they look into the mirror every day for the rest of their life post operation. If you want to ensure safe, beautiful, and natural-looking results, it’s critical to seek out an injector who has the necessary knowledge, skill, and experience.
Lack of Regulations and Best Practice Guidelines
While the products and devices used in nonsurgical cosmetic treatments undergo rigorous testing and regulatory scrutiny, there’s a glaring gap when it comes to the people who actually perform these procedures. The oversight of professionals administering treatments like dermal fillers, botulinum toxin injections, and chemical peels is shockingly minimal.
It’s a little-known fact, but a concerning one: in the UK, doctors, nurses, and aesthetic practitioners who carry out non-surgical procedures, including something as intricate as tear trough fillers, are not legally required to be fully qualified in aesthetic medicine.
Yes, you read that right. Anyone can technically offer these treatments regardless of their training or expertise. This lack of regulation creates a situation where, as a patient, it’s incredibly difficult to differentiate between a skilled, experienced practitioner and someone who may have only completed a short training course that barely scratches the surface of what’s necessary for performing these delicate procedures safely.
Who Is Performing Your Procedure?
Let’s face it, injecting dermal fillers around the eyes requires a nuanced understanding of facial anatomy, precision, and a sharp eye for detail. This isn’t something you can learn in a weekend workshop. So, when non-medical professionals or those with limited training start offering treatments, it introduces an element of risk that patients are often unaware of.
And this is where the problem lies. Patients don’t always know who’s performing their procedure, which leaves them vulnerable to subpar treatments, botched results, or worse, complications that could lead to long-term damage.
Concerns about Lack of Regulations
Now, let’s talk about why this lack of regulation is so concerning. The demand for non-surgical cosmetic treatments is rising rapidly. Everyone is looking for a quick fix to refresh their appearance or smooth out those tired, sunken under-eyes. But as more and more people seek out these treatments, the rise in new practitioners flooding the market has led to an alarming lack of consistency in standards.
While there are some professionals who adhere to best practices, many others cut corners in ways that can compromise the results or, more dangerously, the patient’s safety.
But what happens if something goes wrong? What rights do you have if a procedure doesn’t turn out the way you expected—or worse, causes complications? Patients are often left in the dark when trying to figure out what to do if things go awry. Without strong regulations or clear guidelines in place, you may find it difficult to know where to turn or who’s truly responsible for fixing the problem.
Care Quality Commission
This is where the Care Quality Commission (CQC) comes into play. The CQC is an independent regulator for health and social care in England. Their role is to ensure that all healthcare services—non-surgical cosmetic treatments included—are delivered safely and meet the highest standards of care.
Your trusted friends at Dr Aesthetica understand the importance of this regulation and are proud to announce that we’re registered with the CQC.
CQC-Approved Medical Aesthetics Clinic
CQC-approved medical aesthetics clinics meets strict quality standards, and are safe for patients. CQC-approved clinics are competent and knowledgeable in a field where regulation is sadly lacking in many areas.
Choose a CQC-approved clinic and you can know that you're protected and safeguarded.
Being CQC-registered means that the clinic is not just following voluntary recommendations. Instead, they are held to mandatory standards that ensure every treatment performed is carried out safely, effectively, and with your well-being in mind.
Ask About the CQC
This is something every patient should consider when choosing a practitioner. Ask about your clinic's registration status. Are they following a regulatory body’s standards? Do they have the right experience, skills, and credentials? If the answers aren’t clear or don’t inspire confidence, it’s a red flag.
When it comes to aesthetic treatments, patient safety should always come first.
So, while the lack of overarching regulations in the industry can be disconcerting, patients can take steps to protect themselves by choosing qualified, experienced practitioners who are registered with trusted regulatory bodies like the CQC. It’s the best way to ensure that you’re in good hands- hands that know what they’re doing and are committed to the highest standards of care.
After all, when it comes to something as delicate as tear trough fillers, you deserve nothing less.
The Risks are Still Real
It’s important to remember that while non-surgical treatments such as dermal fillers carry fewer risks compared to surgical alternatives, even when performed by a CQC-approved clinic, they are not risk-free. Any cosmetic treatment, whether surgical or non-surgical, carries the potential for complications. These may range from mild reactions like bruising and swelling to more severe outcomes, such as vascular occlusions or infections.
While there are a number of recommended professional standards for cosmetic treatments set by voluntary organizations, the lack of enforced regulations in the industry means that some practitioners may not follow these guidelines, leaving patients at risk of disappointing outcomes or, worse, permanent damage.
The lack of mandatory regulation also means that providers who fail to meet the required standards of care may not be held accountable for their actions. This is why it’s essential for patients to research their chosen clinic carefully and ask the right questions before proceeding with any treatment. You should always ask about the clinic's qualifications, insurance, and regulatory compliance. If a clinic cannot provide clear, transparent answers to these questions, it’s a red flag.
Dr. Aesthetica: A Trusted and Safe Choice
At the end of the day, remember: You are perfect just the way you are. If you feel that a minor touch-up could enhance your appearance, that’s perfectly valid, but it should never come at the expense of your health or safety.
True beauty is about feeling confident and comfortable in your skin, and that confidence should come from careful, thoughtful decisions made with the guidance of a true professional that is aligned with your needs.
Cosmetic treatments should always be about enhancing your natural beauty, not compromising your well-being.
If you do choose to pursue fillers or any other cosmetic treatment, do so with the knowledge that you are in control of your own health and appearance. Be sure to do your research, choose an experienced, qualified professional, and never compromise on safety. You’re worth it.
At Dr. Aesthetica, we excel in providing safe and effective tear-trough filler procedures, ensuring that every patient receives the best possible care and attention. We are CQC registered, fully insured, and our team is highly experienced in delivering top-tier results. With our extensive training and commitment to excellence, we ensure that every procedure is carried out in a safe and controlled environment.
Don’t take chances with your beauty. If you’re looking for a trusted, experienced team to help rejuvenate your under-eye area, choose Dr. Aesthetica. Our dedication to patient care is reflected in our over 150 five-star reviews on Trustpilot and Google.
Ready for a transformation with a trusted expert? Learn more and book your consultation today.
