FAQs

Please see our most commonly asked questions below

What kind of results can be achieved?

Tear troughs can affect everyone. All genders, ages and ethnicities. Tear trough is technically the depression under the eyes. It can be due to ageing but also genetic reasons and some people often say they’ve had them since they were a child. Tear troughs can feel very frustrating as you may feel you always look tired even when you’re not. Hollowing of the under-eye area can cause dark circles and unnecessarily age the face. Tear trough Filler can fill and rejuvenate the under eye area. It can help the skin appear more smooth. The filler can also improve mild eye bags by providing structural support underneath. If your tear troughs have also given you dark circles, then the elevation of the skin from the filler usually indirectly brightens this area. The filler we use (Teoxane Redensity 2) also has lots of brightening ingredients and antioxidants to improve dark circles. However, filler alone cannot fully remove the dark circles and pigmentation and a combination of skincare and tear trough filler is the best form of treatment. When treating the tear troughs we often use a combination of tear trough and midface filler. Some people who have tear troughs have a flat mid face below them. If you don’t have enough cheek support, the tear trough filler may not stay in place and may give the under eyes a heavy appearance so it is important to ensure enough structural support underneath the eye area. This will also help give harmony and balance across the mid-face. A combination of fillers would be discussed in your consultation (if applicable) as we would need to do a thorough analysis of your face before we could decide the best treatment options.

Who is this treatment suitable and not suitable for?

Tear trough fillers are slightly more complex when it comes to who they are suitable for and the only way for us to know if you are a good candidate for this treatment would be from an in-person consultation. We turn away about one-third of patients who come in for this treatment through assessment that it would not be safe or suitable for them. If you’re the right candidate, the results can be amazing, but having tear trough fillers when you don’t need them or if they are not suitable for you can make the under-eye area look worse.

Tear trough fillers, in principle, can be great for anyone with mild to moderate tear troughs, mild eye-bags and dark circles caused mostly by shadowing and not true pigmentation. But quite a few things need to be considered before you have this treatment. All fillers are made of hyaluronic acid that is a magnet for water. Unlike other areas of the face such as the chin, the under-eye attracts moisture and is susceptible to swelling. Having filler when you don’t actually have a tear trough can cause water retention and puffiness. We always undertreat the tear trough on the day of your treatment. Immediately after injection, there will be a 50-60% improvement but after a few weeks the area will flatten out to around 70% better. We do not advise further correction than this as it is normal to have a slight depression in your under eye area. If you attempt to correct it a hundred percent, there is a risk of it looking too full, especially when you smile. Remember, what looks good in photos often does not look good in person or on facial expression. You may not be suitable for tear trough filler if you have poor skin elasticity as this could lead to puffiness. A good way to test this is to pinch your under-eye skin and if the skin doesn’t spring back within 3 seconds, then it means you’re at high risk for swelling. Or, if you have lots of excess skin, the filler won’t make a difference as it won’t remove the skin and will only add volume. If this is the case, then you may be better off getting surgical treatments.

Finally, you should not get tear trough fillers if you are prone to getting lots of puffiness around your eyes. If you often wake up with puffy eyes and it doesn’t go down throughout the day, then tear trough fillers may not be a good option because your under-eye will attract more water and give you a less than ideal result. We also aren’t able to treat large eye bags as the filler can’t support them. If you have a history of anaphylaxis or allergy to wasp stings, fillers may not be suitable for you. This is because you are likely to be allergic to the filler dissolving enzyme. We always have to ensure we are able to dissolve the filler in an emergency (see below for risks and side effects).

How long does it last?

Tear trough fillers usually last for around 9-12 months. However, this is an average time and for some people, the filler may dissolve more quickly because of their metabolism and for some people, it may last longer.

What is the recovery/downtime?

The downtime for this treatment is minimal. You can go to work and events the same day and will just need to follow the aftercare procedure.

No. of sessions

Sometimes, the first session will achieve the desired results, but some people do need two treatments. You won’t see the final results of tear trough filler for up to one month after treatment. We always undertreat the tear trough on the day of your treatment. Immediately after injection, there will be a 50-60% improvement but after 4 weeks this area will attract fluid and flatten out further. If you need any more filler added, we will do this a minimum of one month after your first treatment. Please note you will be charged the full price for the second treatment as it is an independent treatment with the same level of expertise and risk as the first.

What are the side effects and risks?

Like all medical treatments, there are side effects and risks. Swelling and bruising are to be expected, as is some discomfort. It is also normal to have subtle bumps and irregularities when you first get fillers done, most of this is swelling and will resolve. It is important to follow the aftercare to minimise migration risk and ensure the results last as long as possible. If you have a history of cold sores, any needles to the face can trigger a breakout of it. So please inform us in advance if you have had any cold sores in the past year. There is a very small risk of filler entering a blood vessel and blocking off the blood supply to the skin. This is called a vascular occlusion. As a medical clinic, we have all the equipment and enzymes available to reverse this and dissolve the filler. It is a condition that either happens during the appointment or in the first 48 hours after. We give extensive aftercare advice and are available to get in touch within this period to dissolve it. We have also reviewed every single treatment we carry out in clinic to modify the techniques to minimise the risk.

How painful is the treatment?

There is very minimal pain for tear trough fillers; however, if you are apprehensive about pain or have a low threshold to pain, please ensure you take 1g of Paracetamol 1 hour before the procedure and inform the clinician so we can use numbing cream.

Duration

The appointment is 45 minutes long but the treatment itself takes 10-15 mins. If you have filler in multiple areas, the appointment will be longer. At No Filter Clinic we take our time assessing patients thoroughly, both at rest and with facial expressions so we can ensure the results integrate seamlessly with your features and your muscle movements. Our priority is to also ensure the treatment is safe and carried out to the highest standard.

How will I look straight after?

Immediately after injection, you will have mild redness at the area where the needle was inserted which is actually in the cheek area. On the day, there will be a 50-60% improvement in the tear trough. We only ever fix the tear trough by around 50% because the under-eye area attracts moisture and all fillers are made of hyaluronic acid, a magnet for water. So, if we treated the tear trough to 100% correction on the day of injection, you could be left with a very puffy under-eye area within a week of treatment. This is why it’s imperative to see an experienced medical professional for this treatment. Treating 50% of the area leaves enough ‘space’ essentially for moisture to be attracted and the tear trough to flatten out to a natural-looking and balanced level. If after 4 weeks you felt that you have not had a sufficient improvement, we would recommend you see us for a review appointment to discuss whether further treatment will be sutiable for you or not. Please note you will be charged the full price for the second treatment as it is an independent treatment with the same level of expertise and risk as the first.

How is it done?

We initially undertake a thorough assessment of your whole face to see if the treatment is suitable for you and explain the extent of the possible result. We then disinfect the area and mark out the area that needs correction. We use the only FDA approved filler for the under eye area, it is called Teosyal Puresense Rednesity 2 which also contains brightening ingredients and antioxidants. We use a cannula for the majority of the procedure which is a blunt tip instrument that looks like a needle. It is inserted through a hole created by a needle in the cheek area so there is just one entry point. As it is blunt there is minimal bruising or swelling and it is also much safer for patients as there is lower risk of filler entering a blood vessel.

Can it be reversed?

At No Filter Clinic London, we only use fully reversible fillers. This is because they are safer than permanent fillers and we can dissolve them in the case of an emergency (Vascular occlusion) and if for whatever reason you are not happy with the result. This gives fillers a significant advantage over surgery as they are not permanent. This does not mean you should get fillers just to try them out as the dissolving is not a simple procedure. You should only get fillers done if you have researched them thoroughly, feel comfortable getting the procedure done and are happy accepting the small risks and side effects which are all manageable. If you have a history of anaphylaxis or allergy to wasp stings, fillers may not be suitable for you. This is because you are likely to be allergic to the filler dissolving enzyme (Hyaluronidase). We always have to ensure we are able to dissolve the filler in an emergency (see risks and side effects).

What is the aftercare?

We send a thorough aftercare email to all our patients but please find a summary below.

What to do after treatment

Get some Arnica tablets from any pharmacy, this helps with bruising and swelling. Please do not wear make-up for 4 hours after treatment. In the evening of the treatment, you may gently wash your face and use your regular wash and lotions. Please skip any retinols or acids for the first night. Do not sleep with pressure on the face and try to sleep on your back for 1 week.

If you are uncomfortable with the swelling, please take Loratadine/Cetirizine (normally used for hayfever) to help decrease this. If there is excessive swelling you may contact the clinic to obtain a prescription for steroids to help resolve your inflammation more quickly; prescriptions drugs are not appropriate if the degree is swelling is within normal parameters. Aside from this, there is, unfortunately, no quicker way to resolve swelling as it is a normal bodily reaction to trauma. Wash your face very carefully, applying no pressure to areas treated for 4 weeks.

What NOT to do after treatment

- No strenuous exercise or gardening for at least 1 week.
- Do not massage the area treated for the first 4 weeks following treatment.
- No facials or waxing for the first 2 weeks. Do not take aspirin, ibuprofen or other anti-inflammatory medication for 24 hours after treatment as this may increase bruising. You may take paracetamol or codeine if you are uncomfortable.
- Do not consume alcohol for 24 hours after receiving treatment. This increases the risk of bruising.
- Do not have a sauna, hot tub or go in a tanning booth for 2 weeks after treatment.
- Do not have radiofrequency, IPL, laser or any other heat treatments near the treated area for 2 weeks.

How many mls do I need?

Most people require 1 ml, few patients may need 2 mls in one treatment but they are the minority.

Which fillers do you use?

We exclusively use Teosyal Puresense Rednesity 2 by Teoxane for the delicate tear trough area as it has been extensively studied for this delicate area, it causes the least issues and is also the only FDA approved one for the under eyes. We only ever used hyaluronic acid-based fillers as they are fully reversible. This is essential for your safety.

How do I prepare before the appt?

Before your Appointment

1. Please stop using topical Retinols, Glycolic Acid, Lactic Acids, Salicylic Acid and medication used to treat persistent or cystic acne 5 days before your treatment. This will minimise pain and bruising. However, you do not need to stop if you have been using these for a long time and your skin is likely to flare up without them. If you are on prescription-grade cream to promote skin renewal and reduce breakouts, please get in touch before your appointment so we can discuss it and give individual advice.

2. Please stop using any Vitamin E supplements and Ibuprofen/Neurofen 5 days before your treatment. Please do not stop using any Aspirin (or any other medication) prescribed by your GP.

3. Laser treatments for the face, microneedling and chemical peels must be avoided 1 week before and after the treatment.

4. Please do not drink alcohol 24 hours before and after the procedure.

5. Make sure you eat something before your appointment and are well hydrated. This prevents feeling lightheaded during the procedure.

6. Taking 1 g of Paracetamol (2 tablets) 30 mins - 1 hour before your appointment is advisable as it will significantly reduce any discomfort during the procedure.

7. Please attend the appointment alone. There is limited space in the clinic and anybody with you will be asked to wait outside the building.

8. Please come to the appointment with makeup removed and minimal jewellery.

9. Please note, we are not able to carry out any Dermal Filler treatments if you are due to fly in the next 3 days. This is because of the small risk of vascular occlusion in the first 48 hours. Wrinkle relaxing injections, Profhilo and Aqualyx are fine.

How does the pricing work?

There are different pricing structures. Please see price list for more information.