Overview
For some people, tear trough hollowing is genetic and visible from a young age. For others, it develops gradually as facial structure changes over time. Volume loss through the mid-face, thinning skin, changes in fat distribution and loss of support beneath the eyes can all contribute to a deeper or more pronounced tear trough.
The appearance of the area may also be influenced by lifestyle factors including stress, poor sleep, dehydration and weight loss, all of which can exaggerate shadowing beneath the eyes.
Importantly, not all under-eye concerns are caused by hollowing alone. Puffiness, prominent eye bags, pigmentation, fluid retention and skin laxity may all contribute to a tired appearance and these concerns do not always improve with filler treatment.
How we approach tear trough concerns
At Mirabel Clinic, we approach the under-eye area with caution, precision and a strong emphasis on natural-looking outcomes.
Tear trough concerns are rarely assessed in isolation. During consultation, we consider the relationship between the eyes, cheeks, skin quality and overall facial structure to understand what is truly contributing to a tired or hollow appearance.
Where treatment is appropriate, tear trough filler is performed exclusively by Dr Pippa using conservative techniques and carefully selected products designed for this delicate area. In some patients, alternative or complementary treatments may provide safer, softer and more balanced results than direct filler beneath the eyes.
Our aim is always to refresh the under-eye area subtly and elegantly, never to overfill or dramatically alter facial expression.
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What you may notice
Tear trough hollowing can create a shadowed or tired appearance beneath the eyes, even when you feel well rested. The area may appear sunken, darker or less smooth, particularly in certain lighting or when viewed from the side.
You may notice:
- Hollowing beneath the eyes
- A tired or drawn appearance
- Dark shadowing under the eyes
- Loss of smooth transition between the lower eyelid and cheek
- Increased prominence with fatigue or dehydration
- Makeup sitting unevenly beneath the eyes
For some people, these changes are present from a young age due to natural facial structure, while for others they develop gradually over time.
What is happening in the under eye area
The under-eye area is one of the thinnest and most delicate areas of the face. As facial structure changes over time, there may be gradual loss of volume and support beneath the eyes and through the upper cheek.
Changes in collagen, skin thickness and fat distribution can make the tear trough appear deeper or more noticeable. The way light falls across hollow areas can also create shadowing, making the eyes appear darker or more tired.
Importantly, under-eye concerns are not always caused by hollowing alone. Puffiness, skin laxity, pigmentation and fluid retention may all contribute to the appearance of the area.
What can influence the under eye area
A number of factors can influence how prominent the tear trough appears, including:
- Genetics and facial anatomy
- Ageing and collagen loss
- Mid-face volume loss
- Fatigue and stress
- Poor sleep
- Dehydration
- Weight loss
- Allergies and fluid retention
- Skin quality and elasticity
The under-eye area often reflects both structural changes and wider lifestyle factors.
When to seek advice
If the under-eye area makes you look persistently tired, drawn or older than you feel, professional assessment can help identify the underlying causes and determine the most appropriate treatment options.
Early advice can be particularly valuable because not all under-eye concerns are best treated with tear trough filler alone. Careful assessment helps distinguish between hollowing, puffiness, pigmentation and skin quality concerns to guide the safest and most effective approach.