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Understanding Tear Trough Filler Side Effects: A Comprehensive Guide

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Are you considering tear trough fillers to treat volume loss in the lower eyelids but have concerns and unanswered questions? You’ve come to the right place. 

The Ezra Clinic regularly audits its data on tear trough fillers and recently published the largest study on Tear Trough Fillers in the world. This allows its oculoplastic surgeons to be best placed to advise you about the risks and benefits of tear trough fillers specifically for you. 

Join us on a journey to discover about tear trough filler side effects, make informed decisions and achieve radiant outcomes for a more youthful you.  

Facts About Tear Trough Filler Side Effects  

Tear trough filler treatments (dermal filler injections; hyaluronic acid fillers) are generally very safe, although they have potential side effects, which patients should be well informed about. 

The most common side effects include bruising and swelling, which are typically temporary and resolve on their own. Uncommon side effects can include persistent lumps or the Tyndall effect. 

There are more severe side effects, which are extremely rare in experienced hands, such as infection and arterial injection. 

Are you afraid that your tear trough filler has gone wrong? Trust The Ezra Clinic to fix it. 

10 Tear Trough Filler Side Effects 

  1. Hematoma and Bruising

Bruising is a common and expected reaction that occurs immediately after tear trough filler injections, caused by the puncture of blood vessels around the eyes. Most cases have very little bruising, but this can occur any time a needle punctures the skin. 

With expert techniques and careful planning, bruising can be significantly reduced. Some preventative measures that can be taken include: 

  • using a cannula instead of a needle for injection 
  • applying ice or cold compresses before and after the procedure to constrict blood vessels 
  • avoiding blood-thinning medications and supplements before treatment. 

Post-treatment care can also help minimise bruising. For a few days after the procedure, patients are advised to avoid vigorous exercise, alcohol consumption, and heat exposure. Applying arnica gel or cream to the treated area may also help reduce bruising and swelling. 

While bruising is a common side effect, it is usually temporary and will fade on its own within a week or two. If you have any concerns or bruising persists or worsens, contact the clinic, which is always on hand to help.

  1. Swelling

Mild swelling is typical in the post-treatment period and can be due to the minor trauma from the cannula used to inject the filler. This typically resolves in a number of weeks. 

If the swelling is not resolving, this can be due to a number of factors: 

  • A filler not formulated for the tear trough region was used. At The Ezra Clinic we only use fillers designed for the region's tear trough. 
  • Too much filler was injected 
  • There has been a disruption to the lymphatic drainage 

If swelling persists beyond four weeks, we may recommend dissolving the filler.  

  1. Tyndall Effect

The Tyndall effect is a bluish discolouration that occurs superficially when filler injections are placed too. With the Tyndall Effect, the practitioner must deeply understand the anatomy and precise techniques to avoid this side effect. 

By carefully injecting under-eye fillers at the appropriate depth, the risk of the Tyndall effect can be minimised. Regular follow-up care and communication with the practitioner will also help address any concerns or issues that may arise during the healing process. 

  1. Malar Oedema

Malar oedema can occur as a side effect of tear trough treatment, causing swelling or puffiness in the cheekbone area. 

Malar oedema can happen due to various reasons, such as: 

  • an allergic reaction 
  • excessive fluid retention 
  • improper placement of fillers 

Increasing numbers of patients who had older forms of fillers injected many years ago are presenting to the clinic with malar oedema and tear trough related swelling. Often dissolving the old filler is effective at reducing this swelling. Newer fillers have different hydrophilic properties to prevent swelling. 

It is important to note that malar oedema is a relatively rare side effect, but it is still worth being aware of. By carefully injecting the dermal fillers in the appropriate areas and depths, the chances of malar oedema can be minimised. 

5. Infection 

Infection is a potential side effect of tear trough filler treatments. While it is extremely rare in our clinic, it is important to be aware of this possibility. Infections can occur if proper hygiene and sterilisation protocols are not followed during the procedure. 

In the event of an infection, immediate medical attention is necessary. Symptoms of infection may include increased redness, swelling, pain, or discharge at the injection site. If you suspect an infection after tear trough filler treatment, consult your practitioner promptly for appropriate evaluation and treatment. 

6. Allergic Reactions

Allergies caused by dermal filler can manifest as redness, itching, swelling, or rash at the injection site. 

If you experience any signs of an allergic reaction after hyaluronic acid dermal fillers, such as severe swelling or difficulty breathing, seek immediate medical attention. Allergic reactions should be taken seriously and addressed promptly by a healthcare professional. 

At The Ezra Clinic, our experienced practitioners prioritise patient safety and take all necessary precautions to minimise the risk of allergic reactions during tear trough filler treatments.  

  1. Persistent Lumps

Nodules are small, firm bumps that can develop in the treated area. While nodules are relatively uncommon, they can occur due to various reasons, such as: 

  • Filler migration or clumping 
  • Inflammatory response to the filler substance 
  • Poor injection technique or improper placement of fillers 

To minimise the risk of nodule formation, choosing a qualified and experienced practitioner who follows proper injection techniques and uses high-quality fillers is crucial. Regular follow-up care and communication with the practitioner are also essential to address concerns and monitor the healing process. 

If you notice the development of nodules or any other unusual reactions after tear trough filler treatment, consult your practitioner for appropriate management. 

  1. Asymmetry

Due to the complex anatomy of the tear trough area, achieving perfect symmetry can be challenging. 

While experienced practitioners strive to create balance and symmetry during the treatment, slight differences in the response of the tissues or the injection technique may result in subtle asymmetry. 

Minor asymmetry is often natural and not a cause for concern. However, if you have significant or noticeable asymmetry after tear trough filler treatment and it bothers you, you should consult your practitioner. 

  1. Vascular Occlusion

Vascular occlusion is a rare but serious side effect that can occur as a result of tear trough filler treatments. It happens when the filler is inadvertently injected into a blood vessel or compresses a blood vessel, leading to restricted blood flow. 

When vascular occlusion occurs, it can potentially cause severe complications, including tissue damage and necrosis. There are a few reported cases of blindness following filler injection and therefore it is essential that your practitioner has an in-depth understanding of anatomy and injection technique. There have been no cases of vascular occlusion or blindness at The Ezra Clinic. All surgeons are trained in treating these conditions and have hyalase on hand to dissolve any filler immediately if necessary. 

Symptoms of vascular occlusion may include: 

  • blanching or pale discolouration of the skin 
  • pain 
  • appearance of small purple spots or patches

If you experience any of these symptoms after a tear trough filler treatment, it is important to seek immediate medical assistance. 

  1. Granuloma Formation

Granulomas are a specific inflammatory reaction that can occur in response to certain fillers. When the immune system detects substances that it perceives as foreign but cannot effectively eliminate, it attempts to wall them off, forming granulomas. This reaction is extremely unlikely with modern hyaluronic acid fillers and more common with non-biodegradable fillers. 

Granulomas are characterised by the accumulation of immune cells at the injection site. They can be firm to the touch and may cause discomfort or pain. It's important to note that granulomas develop several months to years after the filler injection rather than immediately. 

The risk of developing granulomas can be influenced by various factors, including the type of filler used, the injection technique, and individual patient factors. Non-biodegradable fillers are more likely to trigger this immune response. 

Who is a Good Candidate for Tear Trough Filler? 

Ideal candidates for tear trough fillers are those with noticeable under-eye hollows, minimal lower eyelid fat, good skin elasticity and a specific type of under-eye hollowing that fillers can effectively correct.  

It is important to have realistic expectations and understand the procedure's benefits and potential risks. For visual examples and more detailed information, visit our page on Before and After Tear Trough Treatment. 

Get Your Tear Trough Filler without Risks at the Ezra Clinic 

At the The Ezra Clinic, we prioritise your safety and satisfaction. Our expert team, led by renowned specialists, ensures your tear trough filler experience is as risk-free as possible. 

We use state-of-the-art techniques and high-quality materials to minimise side effects and maximise results. By choosing The Ezra Clinic, you're not just opting for a cosmetic treatment; you’re investing in peace of mind and quality assurance. 


While filled with potential and promise, the journey to rejuvenation through tear trough fillers requires careful, well-informed navigation with the right professional guide. At Ezra Clinic, we provide you with the highest standards of expertise and a deep commitment to your safety and satisfaction.