Undereye Tear Trough Filler: What You Should Know

What Is Under Eye Fillers?

Under eye fillers are used to treat some conditions such as age related macular degeneration (AMD), glaucoma, and other forms of blindness. They are made from various materials including plastic, rubber or even human tissue. The main purpose of these fillers is to reduce the appearance of your eyes and make them appear younger. There are many different types of fillers available, but they all have one thing in common; they increase the size of your pupil (the small opening at the front of your eye). A larger pupil means you see better and it makes you look younger.

Why Do People Use These Things?

There are several reasons why people use these things. Some may believe that using them will prevent their eyes from getting older because there is no natural aging process in our eyes. Others may think that having a bigger pupil will improve their vision since they are more likely to see well with them. Still others may just like the way they look with them.

How Are They Made?

The most common type of fillers are called scleral shells. These are made from either silicone or polyester. Silicone is the most popular material for making these because it is cheap and easy to come by. The shells are created in a lab and molded into the shape of your eye. Next, the shell is carefully placed under your upper eyelid with a local anesthetic to numb the area.

What Happens During The Procedure?

The procedure itself is pretty straight forward. It generally takes about 10-15 minutes and you should be back to your normal activities within hours. First, your surgeon will measure the size of your pupils to determine the right size shell. They will then make an incision under your upper eyelid and place the shell under the lid. They will then stitch or glue the shell in place.

What Can You Expect Afterward?

You can expect to experience some bruising and swelling as well as sensitivity to light. You should also avoid rubbing your eye for at least a few days after the procedure. Your doctor will give you a topical ointment to help with the swelling and pain. It is recommended to not wear any eye makeup or contact lenses for several weeks after the procedure. You may need a follow-up appointment to have the stitches removed.

What Are The Possible Complications?

As with any medical procedure, there is always a chance of complications occurring. The most common complication is an infection at the site of incision. This can usually be taken care of with proper antibiotics. Other possible complications include:

Chronic irritation of the eye

Partial or complete loss of vision

Eyelid droopiness

Weakened structure of the eye socket due to the sutures coming undone

Overall, there are very few and far between complications that are serious. If you follow all post-op instructions, your chances of having serious complications are very slim.

Some people also experience a mild reaction to the anesthetic. These reactions can range from hives to temporary difficulty breathing. If you notice any of these symptoms, let your doctor know immediately.

What Are The Costs?

Costs of the procedure will vary surgeon to surgeon and facility to facility. The average cost in the United States is around $2,000. Some doctors offer discounts for paying in cash. It is also possible to search online for financing options if you need help affording the procedure.

How Long Do They Last?

It is generally accepted that these types of scleral shells have a shelf life of around 5-7 years. After this time, the silicone will usually start to break down and cause your eye to have a droopiness as well as itchiness and irritation. If you are careful with taking care of them, you may be able to get a few more years out of them. It is always recommended to replace them every few years for safety reasons.


An alternative to scleral shell surgery is known as an epicanthoplasty. This procedure is done on children and young teenagers who are just starting to develop and grow.

The surgery straightens the inner corner of the eye so that the individual will have a more rested appearance in the future. It generally takes less than an hour and can be done under local anesthesia with mild sedation.

Another alternative is known as an orbital prosthesis. Instead of using an eyepatch or scleral shell, this procedure involves the use of a false eye that is placed over your actual eye.

The entire artificial eye is made out of a hard plastic and is painted to match your other natural eye. This option may not be recommended if you have dry eye issues, but it may be a possibility if you are looking for alternatives to improve the appearance of your eye.

Globe Implant

A globe implant is an artificial eye that is completely see-through on the inside. This option will allow you to maintain the appearance that you have a natural eye while still being able to see out of both eyes.

This procedure is much different than simply wearing a scleral shell because it involves cutting a hole in your orbital bone and placing the artificial eye inside your eye socket. The globe implant will be held in place by titanium screws that will be permanently placed in the bones of your face.

The artificial eye is designed to move with your other eye so you should not have any trouble moving your eyes in unison. With this procedure, you can also have a custom iris put into your implant so that your eye will have a natural color and not a plain white color.

This option is usually only recommended for people whose eye was recently removed due to cancer treatment and are not yet ready for a scleral shell. This procedure can also be used by people who have an orbital fracture that requires the removal of their eye.

How Does It Work?

A globe implant involves replacement of your natural eye with an artificial one. The process begins with a CT scan or an MRI in order to take measurements of your orbital cavity and the surrounding area. A model will then be made based on your exact measurements in order to create the implant that will fit you perfectly.

Once the model is made, the implant can then be created using a 3D printer. The implant is then tested on a computer to see if any adjustments need to be made.

After testing, the final product will be ready for surgery.

The surgery itself will involve cutting a small incision in the crease of your eyelid where it meets your skin. The skin and some of the muscle will be cut to expose the bone underneath.

The implant will then be placed inside your eye socket and secured with titanium screws. A plastic ring may be placed around your eyelids to secure the implant as well.


Recovery for this procedure is fairly straight forward. Since the implant is placed inside your eye socket, there is no need for a protective eye covering.

You will need to wear an elastic wrap around your head for about a week after surgery to protect the incision that was made in your eyelid. You should also avoid excessive rubbing of the incision to prevent formation of a blood clot.

You should be able to return to work within a few days and light exercise within a week. Returning to strenuous exercise will take a few weeks.

Advantages and Disadvantages

There are several benefits and disadvantages to this procedure that you should consider before moving forward with surgery.

The primary advantage of a globe implant is that it provides an option for people who have had their eye removed due to cancer treatment and are not yet ready to have a scleral shell implanted. Since this procedure involves cutting directly into the eye socket, it is very safe and reliable.

The main disadvantage of this procedure is that it does not always provide the most natural appearance. Since the implant is made using a 3D printer, the final product may not always look quite as natural or realistic as a scleral shell or a regular glass eye.

Globe implants can also be expensive and are not usually covered by medical insurance. While the procedure itself is fairly safe, there is always a risk of complications with any surgery and anesthesia.

Why get an Eye Implant?

If you are thinking about getting an eye implant, it is important to weigh all of your options first and understand the potential risks and benefits of this procedure. The best way to get a custom fit and realistic looking eye is by having a scleral shell. These are molded to the individual and custom colored to match your natural eye color.

Scleral shells can be expensive and are not always covered by medical insurance, which is why some people decide to have a globe implant instead. A scleral shell takes longer to get after surgery due to the extra steps involved in creating it and painting it to match your natural eye color.

With a globe implant, you will get your new eye much sooner since it does not require any customization.

Another advantage of a globe implant is that they are easier to make. Since each eye is custom made for each patient, this process is still fairly new and some companies have had issues with creating them.

Since each eye implant is custom made, the patient’s specific needs must be taken into account and additional steps must be taken to create a perfect fit.

Globe implants are produced on a 3D printer and do not require any painting or skin care. Since the implant is not painted, there is less of a chance of bacteria forming under the implant which can cause infections.

With scleral shells, all edges must be smoothed out and painted to match the color of your iris and cornea to give it a natural look.

With either procedure, it is still very important to take good care of your eye and follow up with your doctor on a regular basis. It is also important to maintain good overall health by eating a healthy diet, getting adequate sleep, and exercising on a regular basis.

Remember that the eye is one of the most vital organs in the human body and must be protected at all cost. Whether you decide to have a globe implant or scleral shell, it is important to treat your eye with care and avoid any activities that could potentially cause damage.

Even with the best medical treatment, accidents can still happen. If you have sustained an eye injury and your eye has been completely destroyed, medical professionals may suggest having a complete eye reconstruction.

In these cases, doctors may replace your eye with a glass eye or an artificial eye.

A glass eye is made from a type of heat sensitive glass that changes appearance as the temperature around it changes. There are two types of glass eye, the monofocal and the multifocal.

A monofocal glass eye is designed to look realistic from a distance, but appears to be dull and lifeless up close. A multifocal glass eye appears to have depth and a glossy shine from all distances.

An artificial eye, also known as an orbital implant, is a prosthetic device that is usually made from metal alloys, polymers, or ceramic. Theses devices are made in a variety of shapes and sizes and can be designed to imitate a natural eye or can be non-representational.

Whichever you choose, it is important that you feel comfortable with your decision. If you would like to learn more about these procedures, please contact us using the form below.

One of our experts will get back to you as soon as possible with more information.

Sources & references used in this article:

Treatment of tear trough deformity and lower lid bowing with injectable hyaluronic acid by MAC Kane – Aesthetic plastic surgery, 2005 – Springer

Hyaluronic acid injections for correction of the tear trough deformity by VS Lambros – Plastic and reconstructive surgery, 2007 – journals.lww.com

Anatomy and nonsurgical correction of the tear trough deformity by H Hirmand – Plastic and reconstructive surgery, 2010 – cdn.journals.lww.com