What is the Ranking of Fat-Filled Tear Trough in New York City in 2025

Introduction

The under - eye area is a delicate and highly visible part of the face. Tear trough deformities, which can cause a tired, aged appearance, have become a common cosmetic concern in New York City. Fat - filled tear trough treatments and other dermal filler options have emerged as popular non - surgical solutions to address this issue. In 2025, with the continuous advancement of cosmetic medicine, understanding the ranking and best options for tear trough treatments in New York City is crucial for those seeking to rejuvenate their under - eye area.

What are Tear Troughs?

The tear trough is an anatomic area of the face, the hollow located between the upper cheek and the lower eyelid region. As people age, the skin and muscles of the face change. The tear trough becomes deeper, and any circles beneath the eye become darker. The natural loss of collagen with age leads to thinner, more transparent skin in the under - eye area, increasing the visibility of underlying blood vessels and creating a darkened appearance. Genetics can also play a role, with some individuals being born with a more prominent tear trough. The area beneath the eyes is particularly prone to losing volume, as the skin there is thinner and more delicate than other parts of the face. As the volume decreases, the skin can start to sag, creating a hollow or trough - like appearance. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

What Tear Trough Fillers Can Do

Tear trough fillers are designed to address the aesthetic issues associated with tear trough deformities. They can effectively restore lost volume in the crease below the eye and improve the appearance of dark circles and under - eye bags. Hyaluronic acid - based dermal fillers, such as Belotero, Restylane, and Juvederm, are commonly used. These fillers work to reduce the appearance of dark circles and shadowing under the eyes by replenishing volume. The hyaluronic acid in the fillers is a naturally occurring substance in the body that helps plump the skin and increase collagen production, resulting in a more youthful - looking complexion. Using dermal fillers to treat the under - eye area can deliver natural - looking volume restoration and reduce the appearance of fine lines, puffiness, and dark circles. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

Types of Tear Trough Fillers

Hyaluronic Acid (HA) Fillers

Currently, hyaluronic acid (HA) gel fillers are the best choice for the under - eyes for the vast majority of people. They are soft, pliable, and most importantly, reversible. If there is a problem with a lump, bulge, discoloration (Tyndall effect), or bubble from the filler, it can be taken away with an enzyme injection that dissolves the filler. There are many different varieties of HA gel fillers.

• Restylane - L: Many experts still choose Restylane - L as the best under - eye filler. It has the right balance of stiffness, cohesivity, duration of effect (about a year under the eyes), and relatively low swelling. It can also be fine - tailored for deep or shallow injections by modifying the filler through hydration. Dr. Zuckerman uses Restylane - L for tear trough rejuvenation in New York City. It is also the least hydrophilic of hyaluronic acid fillers, minimizing swelling. (Source: https://www.zuckermanplasticsurgery.com/tear - trough - under - eye - rejuvenation - filler/)
• Belotero Balance: This filler is popular for under - eyes because it’s very forgiving for the injector. It is not very stiff and it tends not to lump up or cause discoloration. However, the downside is that it doesn’t provide great lift if there is a deep tear trough. It’s an acceptable choice but not as versatile as Restylane in some experts' opinions. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Juvederm Volbella and Juvederm Vollure: Within the Juvederm family, Volbella is softer and Vollure (also known as Volift outside the U.S.) is stiffer. They cause less swelling than the older variety of Juvederm products and are good options for shallow (Volbella) and deeper (Vollure) injections under the eyes. However, a low incidence of inflammatory nodules (bumps) have been reported to occur after 4 months with Volbella. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Restylane Refyne and Restylane Defyne: These fillers have a different type of cross - linking than regular Restylane, making them more “flexible.” There is a benefit of using Refyne in the “crow’s feet” area, but so far, there is no shown benefit over regular Restylane for the under - eyes. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Restylane Silk: This is the thinnest, softest version of Restylane but it also has the highest swelling capacity. It's not the best choice for the thin under - eye skin, which doesn’t take well to significant swelling. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Juvederm Ultra and Juvederm Ultra Plus: These fillers swell more, are more likely to spread out, causing the treatment to be less accurate and the product to end up in a different place than where it was meant to be injected. Many practitioners have switched away from using them for the under - eye area. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Juvederm Voluma: This thicker version of Juvederm is best for cheeks but not great for under - eyes. It tends to look lumpy and can also create long - term swelling. It’s also resistant to dissolving with hyaluronidase, so it can take several office visits to remove it from the under - eyes. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)

Fat Injections (Fat Transfer or Fat Grafting)

Fat injection is a permanent filler that uses your own fat cells to add volume, similar to injectable synthetic fillers. Many surgeons are reluctant to do under - eye fat injections and may even criticize this procedure. However, some practitioners, like certain doctors in New York City, find it to be safe and effective. The success of fat grafting depends very highly on the technique being used. The fat is processed in a sterile, closed system, and conservative amounts of fat are placed in the deepest level with very small fat parcels in each location. Fat grafting is less predictable than filler because some of the cells being injected will not survive, but even at a 50% survival rate, the benefits can be very worthwhile. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)

Choosing the Right Filler in New York City

Selecting the right tear trough filler in New York City is a decision that should be made in consultation with a qualified medical professional. The best filler for an individual depends on several factors:

1. Facial Anatomy: A person's unique facial structure, including the depth of the tear trough, the thickness of the skin, and the overall contour of the face, will influence the choice of filler. For example, a deep tear trough may require a filler with more lift, such as Restylane - L or Juvederm Vollure, while a shallower trough may be better suited for a softer filler like Belotero Balance. (Source: https://www.michelegreenmd.com/tear - trough - fillers)
2. Skin Concerns: If a patient has concerns about swelling, a filler like Restylane - L, which has relatively low swelling, may be a better option. Those worried about the Tyndall effect (a bluish discoloration) might choose Belotero Balance, which has an ultra - thin and flexible formulation that can eliminate this risk. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
3. Cosmetic Goals: Whether a patient wants a subtle improvement or a more dramatic change will also impact the filler choice. Some may prefer a long - lasting effect, in which case a filler with a longer duration of action, like certain types of Juvederm, might be selected. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

It is essential to have an in - depth consultation with an experienced injector, such as a board - certified dermatologist or plastic surgeon in New York City. Doctors like Dr. Michele Green, Dr. Brett Kotlus, and Dr. Darren M. Smith have extensive experience in tear trough filler treatments and can recommend the best option based on an individual's needs, goals, and medical history. They will evaluate the under - eye area and develop a customized treatment plan. (Source: https://www.michelegreenmd.com/tear - trough - fillers, https://www.drkotlus.com/best - tear - trough - eye - filler/, https://www.darrensmithmd.com/injectables/tear - trough - fillers/)

Procedure and Recovery

Procedure

The first step for having under - eye dermal fillers is to consult with a medical professional. For example, at Dr. Michele Green's office on the upper east side of Manhattan, she will evaluate the targeted treatment area and the skin’s elasticity, confirm the patient is a good candidate for tear trough fillers, and determine the appropriate dermal filler product and the number of syringes required to produce the best results. A local anesthetic will be generously applied to the entire treatment area one hour before performing any injections to ensure that the procedure is as comfortable as possible. Additionally, the dermal fillers used for the under - eye area are often compounded with lidocaine, helping to guarantee that the procedure is as painless as possible. The doctor will inject the dermal fillers directly into the skin in tiny amounts using an ultrafine needle or a cannula. The procedure typically takes about 15 to 30 minutes, depending on the individual and the amount of filler used. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

Recovery

After getting tear trough filler, it is normal to experience some mild swelling, bruising, and redness around the injection site. These symptoms usually subside within a few days to a week and can be managed with ice packs or over - the - counter pain medications such as ibuprofen. Patients should avoid rubbing or massaging the area for at least 24 hours after the procedure, as this can cause the filler to shift or become dislodged. It is also recommended to avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours after the procedure. While the results of tear trough filler are immediate, it may take a few days for the full effects to be visible as any swelling or bruising subsides. (Source: https://www.cangelloplasticsurgery.com/non - surgical/tear - trough - filler/)

Safety and Side Effects

When performed by an experienced provider, tear trough fillers are generally safe. However, there are some potential side effects:

• Mild Swelling and Bruising: These are common side effects and usually resolve within a week. Applying an ice pack immediately after the procedure can help mitigate swelling. To decrease bruising, patients are often advised to discontinue any blood thinners and NSAIDs such as Advil, aspirin, ibuprofen, or Aleve before the treatment. Patients prone to bruising can take arnica forte, an herbal supplement, to help prevent and heal bruises faster. (Source: https://www.michelegreenmd.com/tear - trough - fillers)
• Tyndall Effect: This is a rare side effect that leads to the development of a bluish discoloration after some hyaluronic acid fillers are injected. The injection area can appear blue if the hyaluronic acid filler is injected too superficially. This color change can last several months in the treated area and can be reversed with hyaluronidase to dissolve the dermal filler. (Source: https://www.michelegreenmd.com/tear - trough - fillers)
• Other Rare but Serious Side Effects: These include changes in vision, vascular occlusion, signs of infection at injection sites, allergic reaction to the dermal filler product, worsening bruising or swelling, numbness, and persistent pain. To prevent any serious or adverse side effects from developing, it is crucial to have tear trough filler injections performed by an expert, board - certified injector. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

Ranking and Reputable Providers in New York City

It's challenging to provide a definitive ranking of fat - filled tear trough or tear trough fillers in New York City, as the "best" option can vary depending on individual preferences and needs. However, several providers are highly regarded:

• Dr. Michele Green: A world - renowned expert in the field of cosmetic dermatology, with over 25 years of experience treating patients from around the globe. She is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. Dr. Green offers a host of non - invasive cosmetic procedures, including under - eye fillers. She will assess the under - eye hollows to choose the right tear trough filler for each patient and develop a customized treatment plan. (Source: https://www.michelegreenmd.com/tear - trough - fillers)
• Dr. Brett Kotlus: A cosmetic oculoplastic surgeon. He has extensive experience and specialized training in oculoplastic and cosmetic surgery. He provides insights on different types of under - eye fillers and their pros and cons based on his clinical experience. (Source: https://www.drkotlus.com/best - tear - trough - eye - filler/)
• Dr. Darren M. Smith: A board - certified plastic surgeon with an artistic eye for aesthetics. With over 18 years of experience, he is considered one of the leading specialists in enhancing and rejuvenating the delicate eye region. He offers tear trough fillers at his state - of - the - art facility in Manhattan and uses advanced techniques to ensure safe and effective treatments. (Source: https://www.darrensmithmd.com/injectables/tear - trough - fillers/)
• Dr. Zuckerman: He uses Restylane - L for tear trough rejuvenation in New York City. His treatment helps patients appear rested and refreshed. He also provides guidance on pretreatment guidelines, recovery, and associated risks. (Source: https://www.zuckermanplasticsurgery.com/tear - trough - under - eye - rejuvenation - filler/)

Cost of Tear Trough Fillers

The total cost of tear - trough filler treatment depends on several factors, such as the medical professional performing the procedure, the geographic location of the office, the type of filler used, and the amount of filler needed. Typically, fillers cost $1000 or more per syringe, depending on the exact filler. During the consultation, the doctor will assess the tear trough, cosmetic concerns, and goals to choose the best - suited dermal filler product and recommend the total number of syringes needed and the cost of treatment. While it may be more costly to have the procedure done by a more experienced, board - certified dermatologist or plastic surgeon, it is important to be very selective about the provider to ensure that unwanted side effects are avoided. (Source: https://www.michelegreenmd.com/tear - trough - fillers)

Conclusion

In 2025, tear