Tear Trough Filler vs. Eye Bag Surgery: Which Is Right for You?

Feeling Self-Conscious About Tired Eyes?

If you’re constantly being told you look tired—or feel like your under-eyes are aging you—you're not alone. Many clients come to our Brentwood clinic wondering whether they need surgery to fix their under-eye area, or if a non-surgical solution like tear trough filler could help.

The good news? You have options.

Let’s break down the key differences between tear trough filler and lower blepharoplasty (eye bag surgery), so you can feel confident making the right choice for your needs.

What Causes Under-Eye Hollows or Bags?

Under-eye concerns can come from a few things:

• Volume loss (common with age)

• Thinning skin

• Fat herniation (fat pushing through the muscle wall)

• Poor lymphatic drainage

Some people experience just one of these, while others deal with a combination. That’s why a thorough assessment is key before jumping into any treatment.

What Is Tear Trough Filler?

Tear trough filler is a non-surgical treatment using hyaluronic acid to restore volume beneath the eyes. It works best for:

• Mild to moderate hollowness

• Dark shadows caused by volume loss

• Smoothing the transition from lower eyelid to cheek

  
  

If this sounds like your concern, tear trough filler could be ideal—and it’s one of our most requested treatments. You can learn more in our main tear trough service page.

Pros of Tear Trough Filler:

• No surgery or general anaesthetic

• Quick procedure with minimal downtime

• Instant results (that improve over 1–2 weeks)

• Reversible with hyaluronidase if needed

Cons:

• Not suitable for severe under-eye bags

• Temporary (lasts 6–18 months)

What Is Lower Blepharoplasty?

This is a surgical procedure that removes or repositions fat under the eyes. It’s a more permanent fix, best suited for:

• Bulging under-eye bags

• Loose, sagging skin

• Deep structural issues that filler can’t camouflage

Pros of Eye Bag Surgery:

• Permanent result (can last 10+ years)

• Dramatic improvement in severe cases

Cons:

• Requires downtime (1–2 weeks recovery)

• Surgical risks like scarring or asymmetry

• Higher upfront cost

Filler or Surgery: Which One Is Right for You?

Here’s a simple way to think about it:

• If your under-eye issue is hollowness or shadowing, tear trough filler is likely the better choice.

• If you have puffiness, loose skin, or bulging fat, surgery might be more appropriate.

And if you’re somewhere in between? That’s where a consultation helps—we’ll assess your anatomy and give you honest advice.

The Hybrid Option: Starting with Filler First

For a deeper dive into how tear trough filler actually works and why it’s so effective in addressing under-eye hollowness, be sure to check out our detailed blog: How Under-Eye Filler Works: The Science Behind Brighter Eyes.

Many of our clients start with tear trough filler to see how much improvement they can get without surgery. In some cases, that’s all they need. If surgery is eventually required, you’ll go into it more informed and with realistic expectations.

We also offer subtle cheek filler to support the under-eye area and create an even smoother result.

Final Thoughts: You Don’t Have to Decide Alone

Choosing between filler and surgery doesn’t have to be stressful. We’ll guide you through what’s best for your face, your comfort level, and your long-term goals.

If you’re curious but unsure, come in for a consultation. We’re here to talk you through every option—no pressure, just honest guidance.

Book your tear trough consultation today and let’s find what works for you.

Frequently Asked Questions

Should I get tear trough filler or eye bag surgery?

Tear trough filler is ideal for hollowing or shadowing under the eyes. If you have bulging fat pads or loose skin, surgery may be more effective. A consultation helps determine which option suits your under-eye anatomy and goals best.

How long do results last with tear trough filler?

Under-eye filler typically lasts 6 to 18 months. Longevity depends on your metabolism, lifestyle, and the filler used. Many clients return yearly for subtle maintenance.

Is tear trough filler reversible?

Yes. If you're unhappy with the results, tear trough filler can be dissolved using hyaluronidase—a safe enzyme that breaks down hyaluronic acid.

What are the risks of eye bag surgery?

Risks include swelling, bruising, asymmetry, or scarring. Though rare, these are possible with any surgery. Choosing an experienced, qualified practitioner reduces the likelihood of complications.

Can I try filler before committing to surgery?

Absolutely. Many clients start with filler to see how much improvement they can achieve without surgery. It’s a safe, low-commitment option before exploring surgical solutions.