A tear trough is the shallow groove that runs from the inner corner of your eye downward and outward along the edge of your lower eye socket. Everyone has one, but in some people this groove is deep enough to create a visible hollow or shadow that makes the under-eye area look dark, tired, or sunken. The term comes up most often in cosmetic contexts because the tear trough is one of the first areas of the face to show signs of aging, and it’s a common target for fillers and surgery.
Where Exactly the Tear Trough Sits
The tear trough occupies a specific slice of the under-eye area. It runs from the inner corner of the eye (near the nose) outward to roughly the middle of the pupil line. Beyond that midpoint, the groove that continues along the lower eye socket has a different name: the palpebromalar groove. These two grooves look like one continuous line to most people, but they have different underlying anatomy and tend to appear at different stages of life.
The tear trough itself sits between two sections of the circular muscle that surrounds your eye (the orbicularis oculi). Because the skin here is among the thinnest anywhere on the body, even small changes in the fat and tissue beneath it become visible on the surface. A related landmark, the nasojugal groove, sits slightly below and at a more diagonal angle, corresponding to the lower border of that same eye muscle. In everyday conversation, all of these terms tend to get lumped together as “under-eye hollows,” but practitioners distinguish between them when planning treatment.
Why Some Tear Troughs Look More Pronounced
A visible tear trough can show up at any age. In younger people, it’s usually just a matter of facial bone structure and genetics. Some people naturally have less soft tissue padding between the orbital bone and the overlying skin, which makes the groove more noticeable even in their twenties.
With aging, several things happen at once. The fat pads that sit beneath the eye shift and thin out, the skin loses collagen and elasticity, and the bone of the eye socket gradually remodels, creating a wider orbital opening. All of this deepens the hollow. At the same time, the fat pad just above the groove (inside the orbit) can start to push forward, creating puffiness or under-eye bags that sit right next to the hollow, making the contrast even more dramatic. The result is a tired, aged look even when you’re well rested.
Other factors that make tear troughs more visible include dehydration, allergies that cause chronic under-eye swelling, and pigmentation differences. People with naturally darker periorbital skin may notice the shadowing effect more because the groove creates both a structural shadow and a color contrast.
Severity Levels
Practitioners typically classify tear trough deformities into three levels of severity. A mild (Class I) tear trough involves a shallow groove with minimal volume loss, limited to the area closest to the nose. A moderate (Class II) tear trough extends further outward and includes more noticeable hollowing, sometimes with early puffiness from protruding orbital fat. A severe (Class III) presentation involves deep hollowing, significant fat herniation (visible bags), and often loose, crepey skin. The classification matters because it determines which treatments are appropriate. Mild and moderate cases respond well to non-surgical options, while severe cases often need a surgical approach.
Filler Treatments
Hyaluronic acid fillers are the most common non-surgical treatment for tear troughs. A small amount of gel, typically 0.2 to 0.5 ml per side, is placed deep against the bone or within the muscle layer to rebuild the volume that creates the hollow. The goal is to create a smooth transition between the lower eyelid and the cheek rather than to “fill” the groove to the surface.
Results from tear trough fillers last longer than fillers placed in many other parts of the face. Published data shows an average subjective effect of about 10.8 months, but objective imaging measurements show volume augmentation lasting around 14.4 months. A retrospective study in the Journal of Clinical and Aesthetic Dermatology found significant results persisting up to 18 months, with some patients still showing improvement at 24 months. The under-eye area sees less muscle movement than, say, the lips, which likely explains the extended duration.
Placement depth is critical in this area. Because the skin is so thin, filler injected too close to the surface can produce a bluish discoloration known as the Tyndall effect. This happens because a pocket of hyaluronic acid gel beneath thin skin scatters short-wavelength (blue) light about 10 times more than red light, creating a visible blue tint. To avoid this, experienced practitioners place filler at the deepest possible level, right against the bone or at least beneath the muscle. Using a blunt-tipped cannula rather than a sharp needle for the injection is also strongly recommended, as it reduces the risk of puncturing blood vessels in this vascular area.
Surgical Options
For more advanced tear troughs, especially those paired with visible under-eye bags, surgery offers a longer-lasting solution. The most relevant procedure is a lower blepharoplasty with fat repositioning. Traditionally, lower eyelid surgery simply removed the bulging fat pads, but this sometimes left patients with a hollow, sunken look. The modern approach instead takes that herniated fat and repositions it downward into the tear trough groove, filling the hollow with your own tissue. The procedure is performed through the inside of the lower eyelid, leaving no visible scar.
Fat repositioning addresses both problems at once: it reduces the puffiness above the groove and fills the hollow below it. Because it uses your body’s own fat rather than an injected material, the results are permanent, though your face will continue to age naturally over time.
What Topical Products Can and Cannot Do
Eye creams and serums cannot rebuild lost volume or change bone structure, so they won’t eliminate a true tear trough. That said, certain ingredients offer modest cosmetic improvement. Caffeine stimulates the breakdown of fat cells and can temporarily reduce puffiness and fluid retention in the lower eyelid, which softens the contrast between a puffy lid and a hollow groove. Retinol and its related compounds (like retinaldehyde) have sufficient evidence supporting their ability to decrease fine lines and improve skin thickness over time, which can make the area look smoother and less translucent.
These products work best for people with mild tear troughs where the issue is partly skin quality rather than deep structural volume loss. They’re also useful as maintenance alongside filler treatments, helping the overlying skin look healthier and less crepey.