What Is a Tear Trough — and How Does It Cause Dark Circles?
The tear trough is the natural groove between the lower eyelid and cheek, running from the inner corner of the eye outward and downward. It’s fundamentally a volume deficit, not a pigmentation problem.
The connection to dark circles:
- The hollow casts a shadow that creates the appearance of darkness (shadow-type dark circles)
- Under-eye hollowness makes eye bags appear relatively more prominent
- Filling the tear trough eliminates the shadow — dramatically reducing the appearance of dark circles
Note: Vascular dark circles (visible blood vessels) or pigmented dark circles (melanin deposition) respond differently — these may require additional treatments beyond filler alone.
Why Tear Trough Filler Requires Expert Technique
Tear trough is considered one of the most technically demanding injection sites because:
- Under-eye skin is extremely thin — superficial filler shows lumps or bluish discoloration (Tyndall effect)
- Requires low-viscosity, high-spreading HA formulations
- Overfilling creates a puffy, baggy appearance that’s difficult to correct
Rappoel uses The Chaeum’s low-crosslink formulation (higher flowability) placed via deep periosteal injection technique — placing HA precisely above the orbital bone to avoid Tyndall effect and eliminate puffiness risk.
The Procedure
- Detailed assessment (10 min): Doctor categorizes tear trough type (skeletal/fat/mixed) to determine injection depth and volume
- Anesthesia (5–10 min): Topical cream or local injection anesthesia
- Injection (15–20 min): Fine needle or blunt cannula placement deep at periosteal level with conservative volume
- Post-injection shaping: Gentle massage to ensure even distribution
Results are immediately visible. Minor swelling resolves in 2–5 days. Duration in the tear trough area is typically 9–15 months depending on individual metabolism.
Important Contraindications and Precautions
- Prominent fat herniation (puffy bags) — filler alone has limited effect; consultation required
- Severe hollowness with significant skeletal contribution — may need combined lifting approach
- Avoid pressing or rubbing the under-eye area for 2 weeks
- Return immediately if blanching or pain occurs (vascular occlusion prevention)
Frequently Asked Questions
Contact Rappoel Dermatology Clinic
📍 77, Seocho-daero, Seocho-gu, Seoul, South Korea
🕐 Mon–Fri 10:00–19:00 · Sat 10:00–17:00
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