Facial Ageing
Hollow grooves between the lower eyelid and cheek that can cast a shadow and look like tiredness.
Physician-led assessment · individualized care · Vancouver clinic
Understanding Tear Troughs & Under-Eye Hollows
Maybe people tell you that you look tired when you feel rested, or you've noticed a shadow under your eyes that wasn't there before.
The tear trough is the curved groove where the lower eyelid meets the cheek. Some people have a visible groove from a young age because of how the ligaments and fat pads in this area are arranged. Over time, under-eye fat and the bony rim can change and the cheek can settle a little lower, which deepens the hollow and the shadow it casts.
The under-eye area is delicate, so treatment is planned carefully around what's causing the hollow, whether that's volume loss, thin skin or a tendency to puffiness. At our clinic, our experienced physicians treat tear troughs with hyaluronic acid filler, or with PRF or Autologous BioGel, both prepared from your own blood.
Causes and Contributing Factors
The tear-trough hollow reflects the underlying structure where the lower eyelid meets the cheek, and a groove is visible in many people even when young because of the way ligaments and fat compartments are arranged. With age, fat under the eye can diminish or shift, the bony rim can lose support, and the cheek can descend, all of which deepen the groove. Thin lower-eyelid skin, genetics, and shadowing from lighting can make the hollow appear more pronounced. In some people apparent hollowing sits alongside puffiness or fluid-related fullness, which changes how the area should be approached.
Signs and Symptoms
Common features include:
Assessment
At your consultation, our physicians look at your under-eyes in different lighting and as you look up, down and straight ahead. That shows how much is true hollowing and how much is shadow, puffiness or loose skin. We also check skin thickness, where the bony rim and cheek sit, any lower-lid fullness, and whether you tend to hold fluid. Together this guides whether HA filler, BioGel, PRF or a good skincare routine will serve you best, and we shape a personal plan around your goals, timing and budget.
Cosmetic consultations are complimentary.
Prevention and Ongoing Care
Daily sun protection and a gentle, medical-grade eye-area routine support the thin skin under the eyes between treatments. Hydrating, barrier-supporting products keep the area smooth, and good sleep and lower salt intake help on days when fluid makes shadows look deeper. Our team can recommend products from our online shop that suit your skin.
Treatment Options
These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.
Where puffiness or fluid retention is part of the picture, your physician will explain which option suits you best, since these respond differently from true volume loss.
Uses injectable fillers to restore or reshape facial volume and contour, selected for the structure and balance each area needs.
Uses a concentrate of platelets prepared from a small sample of your own blood to aid skin healing and skin-quality goals.
For the fuller picture, explore the treatment pages above or discuss the options during a consultation.
Medical Assessment
See a doctor if you notice persistent or one-sided swelling, a sudden change, pain, changes in your vision, a lump, or signs that could point to an allergic, kidney or thyroid condition. These are best assessed before any cosmetic treatment is planned.
Frequently Asked Questions
A tear trough is a groove or hollow between the lower lid and cheek, while bags usually mean fullness from fat or fluid above that groove. The two can occur together and are treated differently, so an in-person assessment is the reliable way to tell them apart.
The under-eye area is one of the more technically demanding places to treat, because the skin is thin and there are delicate structures and blood vessels nearby. That's why our experienced physicians assess your anatomy and the cause of the hollow first, and choose between HA filler, BioGel and PRF accordingly. Your physician explains the possible side effects before you decide.
Your face keeps changing with time, so results aren't permanent, and how long they last varies between people and between HA filler, BioGel and PRF. We'll give you a clear idea at your consultation, based on your anatomy and the option that suits you.
Physician Assessment
An assessment can help clarify what may be contributing, which options may be appropriate, and what a reasonable next step could look like for you.
Visit Our Clinic
Anti-Aging Medical & Laser Clinic combines medical assessment, individualized planning, physician oversight, and a broad range of treatment options in its Vancouver clinic.
Bring your questions, treatment history, and goals. Your provider can help you understand appropriate options, expected recovery, and realistic outcomes.
Make an Appointment
Use our consultation form below and the clinic can guide you toward the appropriate starting point.
