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Tear trough: what the term means
Medically reviewed by Dr Sin Yong · Last reviewed · 4 min read
Published 10 October 2026 · Reviewed by Dr Sin Yong
The tear trough is the groove that runs from the inner corner of the eye downward and outward along the junction of the lower eyelid and the cheek. It is tethered by a ligament, the tear trough ligament, which is why it shows as a shadow even when there is no loss of volume. It tends to deepen with age as the fat and bone around it change.
Key facts
Where
From the inner corner of the eye, down and out along the lid–cheek junction
Why it shows
A ligament tethers the skin to the bone (Wong 2012)
Filler in selected cases, energy-based tightening, or surgery; not every tear trough suits filler
Simplified cross-section of the lower eyelid and tear trough. Schematic, not to scale.
Why the tear trough matters for filler
The skin over the tear trough is among the thinnest on the face, so filler placed too superficially can show as a lump or a bluish tint (the Tyndall effect), and filler placed above the malar septum can hold fluid (malar oedema). In one large series of 1,452 tear trough treatments, contour irregularity was reported in 4.6% and the Tyndall effect in 3.3% (Wilde, PRS Global Open 2023).
A ligament that tethers the skin to the bone, combined with age-related changes in fat, bone and skin. Genetics play a large part, which is why some young people have visible tear troughs.
No. Depending on the cause, energy-based tightening, skin treatments or surgery may suit better. Puffy lower lids and fat bags often do not suit filler.
References
Wong CH, Hsieh MKH, Mendelson B. The tear trough ligament: anatomical basis for the tear trough deformity. Plast Reconstr Surg. 2012;129(6):1392-1402. doi:10.1097/PRS.0b013e31824ecd77. source
Haddock NT, Saadeh PB, Boutros S, Thorne CH. The tear trough and lid/cheek junction: anatomy and implications for surgical correction. Plast Reconstr Surg. 2009;123(4):1332-1340. doi:10.1097/PRS.0b013e31819f2b36. source
Wilde CL, Gupta A, Lee S, Ezra DG. Tear trough filler using the three-point tangent technique: lessons from 1452 tear trough applications. Plast Reconstr Surg Glob Open. 2023;11:e5060. doi:10.1097/GOX.0000000000005060. source
