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Aesthetic medicine / Under-eye · Deutsch

Tear trough & dark circles

Under eye filler – look awake again

Dark circles and a deep tear trough make you look tired – even when you have slept well. Depending on the cause, hyaluronic acid, skin boosters or a medical investigation help.

Dr. med. Abdurrahman AltuntasDr. med. Abdurrahman Altuntas · Specialist FMH

In brief

Under eye filler in brief

Physicians distinguish structural dark circles caused by a deep tear trough (nasojugal groove), pigmented dark circles (periorbital hyperpigmentation), vascular dark circles from visible vessels, and eye bags. Only structural dark circles respond to tear trough filler.

  • 1Cause first – if needed with iron levels and blood count from our own laboratory.
  • 2Treatment in 30–45 minutes, usually with a blunt cannula.
  • 3Result immediately, final after about 2 weeks; often lasts 12 months or longer.
Dr. med. Abdurrahman AltuntasMedical responsibility: Dr. med. Abdurrahman Altuntas, Specialist FMH in Internal Medicine and NephrologyUpdated: November 2026

Four types of dark circles – four solutions

We assign your dark circles to one of these types; often there is a combination:

Structural

Tear trough

Volume loss at the lid-cheek junction casts a shadow. Hyaluronic acid evens out the hollow.

Pigmented

Periorbital hyperpigmentation

Brownish discolouration – filler does not help here; skin care or dermatological procedures are more suitable.

Vascular

Visible vessels

Bluish-purple colour because the skin is thin. Skin boosters or polynucleotides can strengthen the skin.

Eye bags

Fat pad herniation

The orbital fat pad bulges forward. Filler is unsuitable; eyelid surgery may be an option.

How the tear trough treatment works

  1. Identify the cause – shadow, pigment, thin skin or eye bag?
  2. Decide – only if hyaluronic acid is suitable do we plan the treatment
  3. Fine technique – small amounts, usually with a blunt cannula
  4. Check – after two weeks we review the result together

Health check first

For dark circles we can measure iron and blood count and ask about allergies and sleep – often more than volume is involved.

When we advise against

With eye bags (protruding fat) or very thin skin, filler can do more harm than good. Then we advise against it and show alternatives.

Risks and side effects

Swelling and bruising are more frequent under the eyes than elsewhere. Rarely: visible nodules, a bluish tint or vascular involvement. Hyaluronic acid can be dissolved.

Questions about under eye filler

Which dark circles can be treated with filler?

Only structural dark circles, where a deep tear trough casts the shadow. Pigment, visible vessels or eye bags require other approaches.

Can dark circles be removed permanently?

Not permanently, but they can be softened considerably and for a long time. Hyaluronic acid in the tear trough often lasts 12 months or longer.

What is the Tyndall effect?

A bluish tint that occurs when hyaluronic acid sits too superficially under the thin eyelid skin. We avoid it through deep placement and small amounts; if needed, the filler can be dissolved.

Can allergies cause dark circles?

Yes. With hay fever, blood pools in the small veins under the eyes ('allergic shiners'). Treating the allergy then helps more than a filler.

How quickly will I see a result?

Immediately after treatment; the final result after about two weeks.

A fresher look, carefully planned

The under-eye area is the most demanding zone of the face – we work with small amounts and great care.

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