The tear trough is a shallow groove that runs from the inner corner of your eye downward and outward along the edge of your lower eye socket. It sits about 2 to 3 millimeters below the orbital rim, right where your lower eyelid meets the upper cheek. Everyone has this anatomical feature, but it becomes more visible with age, genetics, or volume loss, creating a hollowed-out, tired appearance that many people find frustrating.
Where the Tear Trough Sits
The tear trough occupies the inner third of your lower orbital rim, stretching from the inner corner of the eye to roughly the center of your pupil line. It marks the boundary between two different sections of the circular muscle that surrounds your eye (the same muscle you use to blink and squint). A band of fibrous tissue anchors the skin and muscle to the bone along this line, which is why the groove stays fixed in place while the tissue around it shifts over time.
Just below the tear trough, running at a slightly more diagonal angle, is a related groove called the nasojugal fold. This one follows the gap between the eye muscle and the muscle that lifts your upper lip. In casual conversation, people often lump both together as “tear troughs,” but they’re technically distinct structures that can deepen independently.
Why Tear Troughs Become Visible
Several changes happen simultaneously as you age, and they all conspire to make the tear trough more pronounced.
Bone loss: The rim of your eye socket gradually loses volume over the decades. This resorption is most significant along the central and inner portions of the cheek, which means the bony shelf that once supported the under-eye area slowly recedes. The overlying skin and muscle have less structural support, so the groove deepens.
Fat pad changes: The face has distinct compartments of fat stacked in layers. In the tear trough zone, there’s a notable absence of fat beneath the eye muscle, which is part of what creates the visible indentation. At the same time, the thin membrane holding orbital fat behind your lower eyelid weakens. Fat that once sat neatly inside the eye socket can push forward, creating puffiness or “bags” directly above the hollow. This combination of bulging above and hollowing below makes the tear trough look even deeper than it is.
Ligament laxity: The fibrous band that tethers your eye muscle to the bone loosens with age, allowing the cheek tissues to descend. As the cheek drops, the fixed attachment point of the tear trough stays put, creating a sharper V-shaped transition between the lower eyelid and the cheek. Genetics play a role here too. Some people have naturally thinner skin or less under-eye fat, making the trough visible as early as their twenties.
Dermal Fillers for the Tear Trough
Hyaluronic acid fillers are the most common non-surgical treatment. The injector places a small amount of gel along the orbital rim to restore the volume that bone and fat loss have taken away. For the tear trough specifically, practitioners use fillers with low to mid density, low elasticity, and minimal water-attracting capacity. This matters because the skin under the eye is among the thinnest on your body, so a filler that swells too much or sits too firmly will look unnatural or create puffiness.
Results typically last around 10 to 11 months based on how patients perceive the effect, though 3D imaging studies show measurable volume improvement lasting an average of about 14 months. Some research has found significant results persisting up to 18 months, suggesting the under-eye area retains filler longer than many other parts of the face. The relatively low movement in this area and the way cross-linked hyaluronic acid resists breakdown likely contribute to that extended longevity.
Risks of Under-Eye Fillers
The tear trough is one of the trickiest areas to inject, and complications, while uncommon with an experienced practitioner, are worth understanding.
The most characteristic issue is the Tyndall effect: a bluish discoloration visible through the skin when filler is placed too superficially. Because the under-eye skin is so thin, even a small amount of product sitting in the wrong layer can scatter light in a way that looks like a bruise that never resolves. Unlike an actual bruise, it won’t fade on its own in a few days. Without correction, it can persist for months or even years. The area may also feel slightly raised or lumpy. To avoid this, filler needs to be placed deep, right against the bone or at least beneath the eye muscle.
Fluid retention is another concern. Hyaluronic acid naturally draws water to itself, and in some individuals, particularly those prone to puffiness, this can lead to persistent swelling under the eyes that looks worse than the original hollow. In rare cases, this swelling may reflect a low-grade inflammatory reaction to the gel rather than simple fluid accumulation.
Surgical Options
When the tear trough is caused by a combination of bulging fat pads and deep hollowing, surgery can address both problems at once. The most common approach is a lower eyelid blepharoplasty with fat transposition: the surgeon accesses the lower eyelid from the inside (leaving no visible scar on the skin), then repositions the protruding orbital fat into the hollow of the tear trough.
One technique that places the repositioned fat above the eye muscle has shown strong long-term results. In a study following patients for an average of 44 months (over three and a half years), surgical correction was maintained in all patients with high satisfaction and no contour irregularities or significant complications. Unlike fillers, which need periodic retreatment, surgical fat transposition is a one-time procedure with permanent results for most people.
What Skincare Products Can (and Can’t) Do
Topical products are considered supplementary for under-eye rejuvenation. They can improve skin quality, texture, and fine lines in the area, but they can’t replace lost volume or lift descended fat pads. If your tear trough is primarily a structural hollow, no cream will fill it in.
That said, several ingredients have clinical evidence for improving the skin around the eyes. Retinoids (vitamin A derivatives) reduce fine lines and improve skin roughness. Vitamin C has shown improvement in fine wrinkles and skin tone, with one study finding up to 74 percent greater improvement in crow’s feet compared to a control. Niacinamide improves texture, fine lines, and can reduce dark pigmentation that often accompanies tear troughs. Peptides applied for 12 weeks have demonstrated visible improvement in wrinkle appearance in controlled trials.
The persistent challenge with all of these ingredients is penetration. The molecules in topical hyaluronic acid, growth factors, and green tea extract often struggle to reach the deeper layers of skin where they’d do the most good. Vitamin C has stability issues that can render products ineffective if poorly formulated. These ingredients work best as part of a long-term skincare routine that complements, rather than replaces, professional treatments for significant tear trough hollowing.