Under Eye Fillers in Houston, TX
Look as rested as you feel, or as rested as you wish you felt.
The tear trough is the hollow groove that runs from the inner corner of the eye down toward the cheek. As we lose fat and collagen with age, this area becomes more pronounced, creating a shadowed, sunken look that reads as tiredness regardless of how much sleep you’ve actually had. For some patients it’s genetic rather than age-related, appearing as early as the late twenties.
Tear trough filler is one of the most impactful single-area treatments we offer, and also one of the most technically demanding. The under-eye area sits directly over blood vessels and lymphatic channels, and has thinner, more delicate tissue than almost anywhere else on the face. When it’s done well by an experienced provider, the result is genuinely transformative. When it’s done by someone who doesn’t fully understand the anatomy, complications range from lumps and bruising to rare but serious vascular events.
We’re telling you this not to alarm you, but because we think you deserve to know what you’re choosing when you select a provider for this particular treatment. At FACE/FIT, under-eye filler is performed by our board-certified providers who understand the anatomy and who use cannula technique (a blunt-tipped needle that moves through tissue rather than piercing it) to minimize risk.
What Tear Trough Filler Treats
The tear trough area involves several distinct concerns that can look similar from the outside but respond differently to treatment.
True hollow: Volume loss in the tear trough groove itself creates a shadowed indentation that no amount of concealer fully covers. Filler placed carefully in this groove restores the smooth transition between eyelid and cheek.
Under-eye darkness: Some dark circles are caused by the shadow cast by a hollow rather than by pigmentation in the skin. Filler addresses this type of darkness effectively. Pigmentation-based darkness responds better to skincare and laser treatment than to filler, and we’ll tell you honestly which kind you have.
Puffiness-shadow combination: Many patients have both a hollow and a slight puffy area (fat pad) above it, which creates a distinct shadow line. This requires careful assessment before treatment since filler in the wrong location can worsen puffiness. Our providers assess this at consultation.
Age-related or genetic hollowing: Tear trough hollowing happens earlier for some people due to genetic facial structure. Patients in their late twenties and thirties frequently benefit from this treatment, not as an anti-aging measure but as a correction of a feature they’ve always had.
If you're seeking a more lifted, firm, and refreshed facial appearance alongside under-eye fillers, RF Skin Tightening is an excellent complementary treatment, and it's available right here at our clinic.
Why Provider Selection Matters More Here Than Anywhere Else
We want to say something clearly on this page that most medspa websites won’t: tear trough filler shouldn’t be performed by an esthetician, a dental hygienist, or anyone who completed a weekend certification course. The under-eye area has one of the highest complication rates of any injectable treatment area in inexperienced hands, including rare but serious vascular occlusion events.
The qualifications that matter here are: a licensed medical professional (RN minimum, NP or MD preferred), genuine experience specifically with tear trough treatments, knowledge of the relevant vascular anatomy, and access to hyaluronidase (the enzyme used to dissolve filler in case of emergency).
All of those apply to our team at FACE/FIT. Dr. Lindsay Dragos and Kristi Nielo, NP bring clinical training and real anatomical knowledge to this treatment, not a technique learned from a YouTube tutorial.
The Cannula Advantage
Traditional needle injection uses a sharp-tipped needle that pierces tissue at each injection point. Cannula technique uses a blunt-tipped flexible tube that enters through a single entry point and moves through the tissue plane rather than puncturing through it. In the tear trough specifically, cannula technique significantly reduces bruising, lowers vascular risk, and tends to produce more even product distribution.
We use cannula technique for tear trough treatment at FACE/FIT as standard practice. It takes slightly more time than needle injection but produces meaningfully better outcomes and a safer experience.
What to Expect
Tear trough filler takes about 30 to 45 minutes. Topical numbing cream is applied beforehand and the filler contains lidocaine.
Immediately after: Some swelling is normal and expected, and the under-eye area may look puffy or slightly uneven for several days. This is not your result. The under-eye area swells more than almost any other injection site, partly due to the delicate lymphatic drainage in that area. Don’t judge the outcome in the first week.
Days three through seven: Swelling subsides significantly. The real result begins to emerge. Some bruising may appear during this period, even if it wasn’t immediately visible, as bruising in this area can track down from the injection site.
Two weeks out: The true result. Most patients find this is when the transformation is fully visible. This is also when we assess whether any refinement is needed.
After care that matters: Sleep with your head slightly elevated the first few nights. Avoid strenuous exercise and blood-thinning medications or supplements (aspirin, ibuprofen, fish oil, vitamin E) for several days before and after treatment. Arnica supplements or topical arnica can help with bruising.
How long it lasts: Six to twelve months is typical, though many patients find results lasting closer to twelve to eighteen months. The under-eye area tends to hold filler longer than the lips because there’s less movement. Staying hydrated helps maintain results.
Are Under-Eye Fillers Right for You?
Good candidates for tear trough filler have a true hollow or shadow in the under-eye area caused by volume loss rather than fat prolapse or pigmentation. You should be in good general health with no active infections or skin conditions around the eyes. Recent eye surgery is a contraindication and we’d ask that you wait at least six months after any lid procedure before considering this treatment.
Tear trough filler isn’t appropriate during pregnancy or breastfeeding. Patients with a history of severe bruising or bleeding disorders should discuss this at consultation.
When Tear Trough Filler Isn't the Answer
We mention this because it’s important: not every tired-looking under-eye area is a tear trough hollow, and not every tear trough hollow should be treated with filler.
Patients with significant eyelid skin laxity or a prominent lower eyelid fat pad (“festoons”) may find filler worsens rather than improves their appearance by adding volume below existing puffiness. In these cases, we’ll tell you that filler isn’t the right tool and discuss alternatives.
Patients whose darkness is primarily pigmentation-based (a brownish or purplish discoloration in the skin rather than a shadow from a hollow) won’t see significant improvement from filler. Skincare with vitamin C, retinoids, and targeted laser treatment addresses pigmentation more effectively.
When we assess your under-eye area at consultation, we’ll tell you honestly which category you fall into and what approach is most likely to actually help.
Cheek Filler and Tear Trough: Why They Often Go Together
The tear trough doesn’t exist in isolation from the cheek. When the midface loses volume, the cheek descends and the hollow at the tear trough junction deepens. For many patients, addressing midface volume with cheek filler or Sculptra improves the tear trough area significantly without any direct injection under the eye. For others, both areas benefit from treatment at the same visit.
We assess this at consultation so you’re not paying for a direct tear trough treatment when lifting the cheek would accomplish the same thing more safely and with better overall results. See our cheek fillers page and Sculptra page for more detail on those options.
BEFORE & AFTER
Tired of looking tired?
Book a consultation at FACE/FIT Houston and we’ll assess your under-eye anatomy honestly, explain what’s causing what you’re seeing, and tell you whether tear trough filler is the right solution or whether a different approach would serve you better.
5 STAR AESTHETIC PRACTICE
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