American Society for Dermatologic Surgery. New survey results showcase dermatologists as the primary influencer for patients' cosmetic procedures and skin care decisions. 2023. https// (accessed 11 January 2023)

Anido J, Fernández JM, Genol I, Ribé N, Pérez Sevilla G Recommendations for the treatment of tear trough deformity with cross-linked hyaluronic acid filler. J Cosmet Dermatol. 2021; 20:6-17

Gorbea E, Kidwai S, Rosenberg J Nonsurgical tear trough volumization: a systematic review of patient satisfaction. Aesthetic Surgery Journal. 2021; 41:(8)NP1053-NP1060

Tear trough filler study shows high patient satisfaction and low rate of serious complications. 2021. https// (accessed 11 January 2024)

Nikolis A, Enright KM, Berros P, Sampalis JS Safety of infraorbital hyaluronic acid injections: outcomes of a meta-analysis on prospective clinical trials. J Cosmet Dermatol. 2023; 22:2382-2390

Undereye tear trough filler: what you should know. 2023. https// (accessed 11 January 2024)

From extreme to mainstream: The future of aesthetics injectables. 2021. https// (accessed 11 January 2024)

Stutman RL, Codner MA Tear trough deformity: review of anatomy and treatment options. Aesthetic Surgery Journal. 2012; 32:(4)426-440

Victorian Cosmetic Institute. Why I stopped filling tear troughs…. 2021. https// (accessed 11 January 2024)

Wong CH, Hsieh MKH, Mendelson B The tear trough ligament: anatomical basis for the tear trough deformity. Plast Reconstr Surg. 2012; 129:(6)1392-1402

The safety of tear trough deformity treatment: an overview

02 February 2024
Volume 13 · Issue 1


The use of minimally invasive cosmetic interventions is constantly growing, and tear trough deformity treatment using dermal fillers is one of the non-surgical procedures that is in increasing demand. However, there is also growing public concern about the safety of this treatment option, and patients may be particularly anxious due to the proximity of the eyeball to the injection site. In this article, Francesca Ramadan outlines the risks associated with this procedure and the elements required for careful patient consideration and selection.

In 2021, research conducted by McKinsey & Company indicated that the global aesthetics injectables market could grow by 12–14% annually over the following 5 years (Leclerc et al, 2021); as we enter 2024, 3 years into McKinsey's 5-year projections, it certainly seems that the use of minimally invasive cosmetic interventions is constantly growing, with 70% of consumers who took part in the 2023 American Society for Dermatologic Surgery's Consumer Survey stating that they were currently considering a cosmetic procedure. Indeed, tear trough (TT) treatment, in which dermal fillers are injected into the ‘under eye’ area (the infraorbital region), falls under this category of non-invasive cosmetic procedures that are in growing demand.

By adding volume through subcutaneous filler injection, TT treatment aims to address an individual's ‘dark circles’ or what is referred to in aesthetic medicine as a ‘TT deformity’, which, despite its name, is typically a genetically inherited trait or a natural consequence of the structural changes associated with ageing, including increased skin laxity, reduced soft tissue volume, changes in the orientation of retaining ligaments and resorption of bone (Nikolis et al, 2023).

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