Undereye Treatments


Tear troughs are the area starting from the inner corner of the under eye, extending to the outer corner and down to the cheek. This area will naturally have slight hollowing but due to factors such as genetics and age, this impression can become much deeper and darker than desired. These concerns may be further worsened by shadowing, enhancing any pre-existing depth and darkness.

When the tear trough is seen as overly hollowed, there are many negative associations, including unfairly ageing your appearance and perpetually looking tired.


To treat this extremely delicate area, an experienced dermal injectables physician with skill, proficiency and an eye for details is required.

Tear trough treatment may be the right treatment option for you if you are after the following:

  1. To appear well-rested, refreshed and rejuvenated;
  2. Desire to look younger.

Candidacy will be determined upon physical examination of the eye areas – this includes eyelid shape, orbital morphology, lower lid tone, volumetric and skin analysis.



The eyes are in constant motion, and perhaps more than we realise (when squinting or smiling, for example), which affects the surrounding areas. This makes it essential to see an experienced injector who will recommend the most appropriate amount for injecting in the tear trough as the tear trough is one of the most complicated areas to inject. It is also imperative that patience is exercised and that this area does not become over-treated, which will result in overfilled tear trough, giving an unnatural look


Proper injecting technique is a crucial component in ensuring that small white ‘bumps’ do not appear several months after your treatment. Tear trough correction is very common worldwide and correcting misplaced treatment from treatment elsewhere is a very common procedure at our clinic. Additionally, utilising the proper volume & contour treatment product is imperative as one should be chosen that provides lift, whilst not attracting water to the area. Both of these factors will ensure that the shape remains smooth and consistent long after your appointment.


Loss of fat pads and orbital bone all contribute greatly to the darkening and hollowing of the tear trough area; all of which further age you. Most people only inject the middle section of the under eye area to inner eye corner area but it is also important to be able to see and treat the outer section of the under eye area (which is very often neglected or under-treated) to achieve a smooth, blended look.

Beyond The Box

We think far ahead before we pick up our syringe and inject. Many factors come into our mind when we treat your under eye areas. It is crucial to make the correct diagnosis for the reason of undereye hollowing – is it due to cheek deficiency or true undereye hollowing, or both? Without addressing the actual underlying cause, the undereye area will not look well-treated.

Tear Trough Treatment


Purpose of Tear Trough Treatment

Classification of Morphology of the Periorbital Volume Loss Patterns

Image Credit: Codner M, Hirmand H. Plastic Surgery Key. 2016. Lid–Cheek Blending: The Tear Trough Deformity. [online] Available at: https://plasticsurgerykey.com/lid-cheek-blending-the-tear-trough-deformity/ [Accessed 14 June 2020].

Clinical Dosage

The clinical dosage is solely determined by:

  1. Volume of cheeks
  2. Degree of undereye hollowing
  3. Volume of temples

Tear trough treatment may require multiple sessions with graduated treatment approach due to the anatomical complexity and unforgiving nature of the area.

Areas To Be Treated

If there is cheek volume deficiency, this needs to be treated first.

Once the cheeks are adequated volumised, this often results in reduction of lid-cheek junctions and may indirectly improve the tear trough without the need for further treatment.

Pain Relief

Most patients do not require any form of anaesthesia as the procedure is very tolerable.

If needed, ice and topical anaesthesia are available.

There is anaesthetic agent in the treatment which will make the procedure even more tolerable.

Injecting Methods

As usual, Dr Ricky and Eleventh Heaven™ do not believe in one blanket method to inject due to individual anatomy and needs. Dr Ricky is very fluent in both the traditional “sharp” needle techniques and more advanced & challenging “cannula” method.

Cannulation technique is generally used to avoid bruising and increase safety.

Product Choice

Product selection is solely a clinical decision based on the factors discussed above.

Whilst our patients do not ask about the brand or name of the product because of the trust they have bestowed upon us, you can be assured we only use premium and Australian government approved product that we have sourced from authorised and genuine supplier. In addition, Eleventh Heaven™ only uses volume & contour treatments from reputable manufacturers and products that are backed up by sufficient clinical data.

With our years of experience and numbers of patients treated, we have used and trialled most of the premium & approved volume & contour treatments available in Australia. Eleventh Heaven™ has therefore gathered enough experience and knowledge about the different rheological properties of various volume & contour treatments to select the best and safest products available.

Generally, a special volume & contour treatment designed specifically for the undereye areas is used. Appropriate product with corresponding technology/rheology will be selected based on your tissue/skin thickness.

* As volume & contour treatment is classified as prescription-only medicine in Australia, we are not able to name the brands.

* Please be aware there are many counterfeit injectable products due to illegal importation into Australia. 

Tear Trough Procedure

  1. Detailed consultation and contraindications screened.
  2. Physical evaluation of the undereye & surrounding areas.
  3. Pre-procedure: Antiseptic wash.
  4. Disinfection of the face again with Chlorhexidine and Ethanol.
  5. A dermal filling cannula will be introduced.
  6. Your tolerance and progress is monitored throughout.
  7. You might be required to sit up or animate during the procedure multiple times throughout for aesthetic outcomes.
  8. Disinfect and pressure/massage may be applied.

Procedure Downtime

Swelling is possible and common for the first 48 hours. Any swelling and bruises after 24 hours can usually be covered with makeup easily.

Potential Side Effects/Complications

As with all medical procedures, side effects or complications are possible. These are usually very mild, minor and self-limited.


  • Swelling
  • Bruises
  • Possible asymmetry
  • Possible need for further treatment/product


  • Delayed allergic reaction
  • Granuloma
  • Infection

Very Rare

  • Vascular occlusion causing skin necrosis leading to scarring if not treated early
  • Blindness

Investment Guidance

Please refer to our Treatment page.

Consultation Request

For consultation, please contact us on 07 3067 7411.

Online booking is also possible.