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Whether tear trough or cheek filler is more appropriate for under eye concerns depends on the individual anatomy. Where hollowing is structural and the mid face has adequate volume, tear trough filler may be most appropriate. Where mid face volume loss is contributing to the under eye appearance, cheek filler often produces a better result.

The under eye area is one of the most common presenting concerns at cosmetic injectable consultations, and one of the most frequently mismanaged. Whether tear trough filler, cheek filler or a combination is the most appropriate approach depends entirely on the individual anatomy, which is why individual clinical assessment before any treatment recommendation is essential. At Core Aesthetics in Oakleigh, Corey Anderson, AHPRA registered nurse (NMW0001047575, registered since January 1996), assesses the orbital and mid face area together before making any treatment recommendation.

Understanding under eye Hollowing

The under eye area is shaped by several interacting anatomical factors. The orbital rim, the position and fullness of the orbital fat pad, the degree of mid face volume, skin quality and the ligamentous attachments in the periorbital area all contribute to whether the under eye looks full and supported or hollow and shadowed.

Key Considerations

“Good information changes the quality of the decision.”

This means that the under eye appearance is not always driven by the tear trough itself. In many clients, what appears to be a tear trough concern is significantly influenced by mid face volume loss, the cheeks have flattened and lost the structural support they once provided to the orbital area, making the under eye appear more hollow than it would with adequate mid face volume. In these cases, addressing the cheeks may produce a better improvement in the under eye appearance than going directly to the tear trough.

When Tear Trough Filler Is Appropriate

Direct tear trough filler is most appropriate for clients where the under eye hollowing is structural and specifically located at the tear trough groove, skin quality is adequate to accept product without risking visibility, the mid face has sufficient volume to support the orbital area, and the client is an appropriate candidate following full orbital and facial assessment.

What This Means in Practice

Tear trough treatment is one of the most technically demanding areas in cosmetic injectable practice. The risk of product being placed in the wrong layer, too superficially, causing a visible or bluish appearance (Tyndall effect) is real and primarily related to product selection and injection depth. Not every client presenting with under eye concerns is an appropriate candidate for direct tear trough treatment. Read more about tear trough treatment at Core Aesthetics.

When Cheek Filler Addresses under eye Concerns

For clients where mid face volume loss is contributing to the under eye appearance, cheek filler can produce an indirect improvement in the tear trough by restoring the structural support from below that reduces the apparent depth of the under eye hollow. This indirect approach is in many cases safer and produces a more natural result than direct tear trough treatment for clients where the mid face contribution is significant.

The assessment determines the degree to which mid face volume is contributing. In some clients it is the primary driver. In others it is a contributing factor alongside a genuine tear trough concern. In a minority of clients the tear trough concern is truly isolated and direct treatment is the most appropriate approach. Read more about cheek filler at Core Aesthetics.

The Assessment at Core Aesthetics

At your consultation, Corey Anderson will examine the orbital area and the mid face together. He will assess the specific pattern and degree of hollowing, the skin quality, the mid face volume and the relationship between these areas. He will then recommend the approach that is most appropriate for your individual anatomy and present the realistic expected outcome honestly.

Read about the tear trough consultation at Core Aesthetics and about the cheek filler consultation.

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Open Tuesday to Saturday by appointment.

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Related: Read more about cheek filler at Core Aesthetics and book a consultation at Core Aesthetics, Oakleigh.

General Information Only. This article is general in nature and does not replace a consultation with a qualified health practitioner. Treatment outcomes, suitability and risks vary by individual. Any medical or prescription treatment options can only be discussed and provided where clinically appropriate following an individual assessment.

Written and reviewed by Corey Anderson, Registered Nurse and Cosmetic Injector  |  Last reviewed: April 2026
AHPRA Registration: NMW0001047575 (Nurse, registered since January 1996)  |  Core Aesthetics, Oakleigh VIC 3166
All prescription treatments are assessed and administered by an AHPRA registered health practitioner. Suitability is determined individually at consultation.