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The tear trough forms a shadow below the lower eyelid and can cause a tired appearance. The tear trough shadow can be lessened using filler. This can be combined with a cheek lift to give more support to the lower eyelid and a refreshed appearance. The tear trough and lower eyelid area can be prone to swelling so this treatment must be done cautiously and over minimum of 2 sessions if there is any concern about the likelihood of lid swelling. The tear trough area has important blood vessels which connect with the eye circulation and so must be approached with great care. The tear trough filler treatment is done using a cannula to minimise trauma to the delicate tissues of the lower eyelid and to lessen the risks to the eye circulation.