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Under-Eye Hollow & Tear Trough Treatments
Clinical management of infraorbital hollowing and tear trough deformity
Under-eye hollows (tear trough deformity) create a shadowed, tired appearance even when well-rested. The hollowing occurs where the thin periorbital skin meets the thicker cheek skin, and deepens as orbital fat pads descend and mid-face volume diminishes with age. Doctor-led assessment is critical in this area — the under-eye is one of the most technically demanding areas to treat, and not all patients are suitable candidates for filler.
Aetiology & Contributing Factors
Most skin and aesthetic concerns are multifactorial. Clinical assessment helps identify which contributing factors are most relevant in your case before treatment is selected.
- Age-related loss of orbital and mid-face fat volume
- Thinning of the already-delicate periorbital skin with age
- Descent of sub-orbicularis fat pads creating a visible groove
- Bone resorption in the infraorbital rim
- Genetic predisposition — some patients have prominent tear troughs from a young age
- Dehydration and poor skin quality accentuating the hollow appearance
- Allergies and chronic sinus congestion contributing to periorbital darkening
Clinical Presentation
Presentation varies by skin type, severity and duration. These are common clinical signs we assess during consultation.
- A visible groove or depression running from the inner corner of the eye towards the cheek
- Dark shadows under the eyes creating a tired, aged appearance
- A sunken or hollow look beneath the lower eyelid
- Loss of smooth transition between the lower eyelid and cheek
- Under-eye puffiness or bags above the tear trough hollow
- Concealer settling into the groove and accentuating the shadow
Evidence-Based Treatment Modalities
Treatment selection is individualised following clinical assessment, taking into account disease severity, Fitzpatrick skin type, medical history and patient goals. You can also review our consultation standards before booking.
Dermal Fillers treatment for under-eye hollows
Hyaluronic acid tear trough filler can restore volume in the infraorbital hollow, reducing shadowing and creating a smoother lid-cheek junction. This is a technically demanding area — only experienced doctors should perform this treatment. Suitability is carefully assessed during consultation.
Profhilo treatment for under-eye hollows
Profhilo bio-remodelling can improve periorbital skin quality, hydration and elasticity. It is particularly useful for patients with thin, crepey under-eye skin where filler may not be appropriate. Suitability confirmed during consultation.
Polynucleotides treatment for under-eye hollows
Polynucleotide treatments stimulate tissue repair and regeneration in the delicate under-eye area, improving skin quality, thickness and hydration. They offer a skin-quality approach where filler is not suitable. Suitability confirmed during consultation.
Why we start with a consultation
Every treatment begins with a medical assessment. We need to understand your medical history, current health, skin condition and concerns before prescribing any procedure. This protects your safety and ensures the treatment is clinically appropriate for you.
During your consultation, Dr Langdon will explain what the treatment can realistically achieve, any risks specific to you, and whether an alternative might be more appropriate.
All bookings are subject to our Booking Conditions.
Not sure what you need?
Try our free AI skin analysis to identify your main concerns and see suggested treatments.
Start free skin analysis →Clinical FAQs: Under-Eye Hollows
These answers cover common practical questions. For individual diagnosis and treatment advice, book a medical consultation.
Plan Your Next Step
Use these links to review consultation standards, check treatment pricing, and request a doctor-led assessment.
Clinical Summary
Clinical Governance
- Tear trough treatment is performed exclusively by experienced doctors trained in advanced periorbital injection techniques
- We carefully assess suitability — not all patients are candidates for under-eye filler, and we are honest about alternatives when filler is not appropriate
- Conservative, natural results are prioritised — the goal is to reduce shadowing without creating puffiness or an overfilled appearance
Book a Consultation
Request a medical assessment for your under-eye hollows with our clinical team.
Book NowCall 01628 202028Not sure what you need?
Try our free AI skin analysis to identify your main concerns and see suggested treatments.
Start free skin analysis →Related Conditions
Explore related condition pages for differential context and linked treatment options.
Further Reading & Clinical References
The following external resources provide independent clinical and regulatory information.
- Caring for your skin— BAD
This content is for informational purposes only and does not constitute medical advice. Individual suitability for any treatment is assessed during a consultation. Always seek the guidance of a qualified medical professional with any questions regarding a medical condition or treatment.
- CQC registered clinic — regulated and inspected
- Doctor-led clinical oversight by Dr Selena Langdon (GMC 6159259)
- Complaints process and patient rights
Page last reviewed: March 2026
Reviewed by Dr Selena Langdon, Medical Director (GMC 6159259) — Last reviewed: February 2026
Request a Clinical Assessment
Book a medical consultation to discuss diagnosis and an individualised treatment protocol.