Home » Treatment » Tear Trough & Undereye Hollowing

Tear Trough & Undereye Hollowing

Under-Eye Rejuvenation Sydney | Thermage & Rejuran | MA360
Thermage FLX Eye · Rejuran · Biostimulator

Natural under-eye rejuvenation in Sydney

Look fresher—not different. MA360 plans under-eye treatment around the cause of tired-looking eyes, with a focus on gradual skin firming, smoother texture and collagen support rather than automatically adding volume.

Our three featured pathways are Thermage FLX Eye, Rejuran and carefully selected biostimulator care.

Crepey skin, fine lines, hollowness, dark circles and eye bags may look similar in the mirror, but they need different solutions. Your plan begins by separating skin quality and laxity from pigment, fluid and lower-eyelid anatomy.

Book an under-eye consultation Compare the three options
  • Doctor-led assessment
  • Chatswood & Hurstville
  • Natural, staged treatment planning

Real MA360 under-eye results

Before and after under-eye rejuvenation with Rejuran and biostimulator at MA360 Rejuran + biostimulator under-eye case Before and after natural under-eye rejuvenation showing softer hollowing and fine lines Hollowing + fine-line rejuvenation case

These photographs show individual cases at different stages of care. They are not a promise of outcome; suitability, treatment method and healing vary between patients.

Three skin-first pathways

Choose the layer—not just the product

Thermage FLX Eye, Rejuran and biostimulators can all support natural-looking rejuvenation, but they do different jobs. The right starting point depends on whether the dominant change is laxity, delicate skin quality or deeper collagen and structural support.

Non-invasive radiofrequency

Thermage FLX Eye

Uses a dedicated eye tip to deliver controlled radiofrequency energy for selected upper- and lower-eyelid fine lines, crepey texture and early laxity. Change is gradual and does not add volume.

Often considered for: patients who want non-surgical eye-area firming with generally limited interruption to daily routine.

Explore Thermage FLX Eye →
Polynucleotide skin quality

Rejuran i

Designed for delicate periocular skin, where fine crepiness, texture and resilience matter more than replacing deeper volume. A course and review plan may be discussed according to the skin concern.

Often considered for: thin, dry-looking or finely creased under-eye skin where a gradual skin-quality approach fits.

Explore Rejuran for under-eyes →
Gradual collagen response

Biostimulator

May be considered to support collagen, skin thickness or selected structure over time. Products behave differently and not every material or placement is appropriate directly beneath thin lower-eyelid skin.

Often considered for: selected patients who need broader collagen or tissue support as part of a carefully staged plan.

Compare Rejuran vs biostimulator →

Sometimes the most natural plan combines layers. For example, Thermage FLX Eye may address selected laxity while Rejuran supports delicate skin quality. A biostimulator may suit broader tissue support—but combinations should follow diagnosis, not a preset package.

More real patient journeys

Natural under-eye results in context

These MA360 photographs show different concerns and treatment pathways. Click any image to read what was assessed and which approach was used.

Before and after eye rejuvenation and eye-bag reduction at MA360
Lower-eyelid rejuvenationA case involving eye-bag and lower-eyelid assessment.
Before and after male under-eye rejuvenation with eye-bag reduction and Rejuran i
Softer puffiness and shadowEye-bag reduction with Rejuran i skin-quality support.
Before and after eye-bag surgery showing a smoother natural lower-eyelid contour
When bags—not skin quality—dominateA surgical pathway for prominent lower-eyelid fullness.

Individual results vary. Images are published for educational context and do not predict another patient’s outcome. Treatment suitability requires consultation.

Diagnosis before treatment

Not every dark circle is a tear trough

Several changes can overlap in the same person. Treating the wrong one can leave the darkness unchanged or make puffiness more noticeable.

01 Hollowing and shadow

A groove between the lower eyelid and cheek can cast a shadow, especially in overhead light.

02 Pigmentation

Constitutional pigment, rubbing, dermatitis or post-inflammatory colour may create brown darkness.

03 Thin, translucent skin

Visible muscle and vessels can give the area a blue, purple or reddish tone.

04 Texture and laxity

Fine lines, crepiness and reduced support can scatter light and deepen the tired appearance.

05 Bags or fluid

Protruding fat, malar oedema or fluid retention creates fullness, not a simple volume deficit.

Some changes need medical review first. Persistent one-sided swelling, pain, redness, a rapidly changing eyelid, visual symptoms or a new lesion should not be treated as a routine cosmetic concern.

Matching cause to treatment

Which under-eye pathway may fit?

These are discussion pathways, not automatic recommendations. The lower eyelid, cheek, skin and eye-bag anatomy need to be examined together.

Main concern
Assessment focus
Possible direction

True tear trough hollow

Depth of the groove, cheek support, skin thickness, lower-lid tone and whether bags or fluid are present.

Conservative hyaluronic-acid volumising treatment, cheek support or no treatment if the risk-benefit balance is poor.

Brown pigmentation

Type and depth of pigment, melasma, dermatitis, rubbing, skin tone and risk of post-inflammatory pigmentation.

Skin care, sun protection and selected pigment treatment. Filler does not remove pigment.

Thin or crepey skin

Fine lines, barrier health, dryness, pigment risk, eye health and tolerance for visible recovery.

Thermage FLX Eye, Rejuran i or another selected skin-quality pathway may be discussed, depending on whether laxity or skin texture is dominant.

Eye bags or puffiness

Fat prolapse, fluid, malar bags, lid laxity, skin excess and whether the fullness changes during the day.

Surgical or eye-bag assessment may be more useful. Adding filler can worsen heaviness in an unsuitable patient.

Mixed dark circles

The relative contribution of shadow, pigment, vessels, texture, bags and mid-face support.

A staged plan that treats the dominant cause first and reviews the result before adding another procedure.

Treatment options

Under-eye treatments work at different layers

The natural-looking result usually comes from choosing the smallest suitable intervention for the right tissue—not using every option at once.

Firming without volume

Thermage FLX Eye

Non-invasive monopolar radiofrequency with a dedicated eye tip may suit selected fine wrinkles, crepey skin or early upper- and lower-eyelid laxity. It does not fill a tear trough, remove prominent eye bags or reproduce surgical tightening. Temporary redness, swelling or tenderness can occur.

Delicate skin quality

Rejuran i

Polynucleotide treatment may be discussed for fine crepiness, texture and resilience rather than structural hollowing. Current evidence is promising but still limited and variable. Small raised bumps, redness, swelling and bruising are expected possibilities after injection.

Collagen and support

Biostimulator care

Biostimulatory materials may support a gradual collagen response, skin quality or selected structure. The category covers different products; some cannot be simply dissolved and not every material is suitable for direct lower-eyelid placement. Product, plane and anatomy matter.

True hollow or shadow

Conservative volume support

A carefully selected hyaluronic-acid volumising treatment may soften a true hollow, while cheek support can sometimes improve the lid-to-cheek transition. It does not treat pigment, and excess product can create puffiness, blue-grey colour or an unnatural contour.

Surface and firmness

Laser or energy-based treatment

Selected resurfacing or tightening treatments may help fine texture, pigment or mild laxity. The device must match the target, and treatment near the eye requires appropriate eye protection. Redness, swelling, pigment change, scarring and eye irritation are possible.

Structural treatment

Lower-eyelid surgery

Prominent fat bags, significant skin excess or lower-lid laxity may be better suited to surgical assessment. Lower blepharoplasty can address anatomy that filler cannot, but it has a different recovery period and risks, including scarring, asymmetry and eyelid-position change.

Evidence in context

Promising options, measured expectations

Research supports potential improvement from radiofrequency, polynucleotides and facial biostimulators, but it does not guarantee an under-eye result. A systematic review of radiofrequency found measurable improvement in skin laxity across facial and body studies. A 2025 polynucleotide review included nine small, low- to moderate-quality studies, while a recent biostimulator review also called for more long-term, standardised evidence. Eye anatomy, product choice, technique and realistic goals remain central.

Safety and recovery

Under-eye safety depends on the method

The eyelid area is thin, expressive and prone to visible swelling. Non-invasive energy treatment and injectable skin-quality care have different risks, and even a subtle treatment deserves careful screening.

Thermage FLX Eye

  • Temporary redness, swelling, warmth or tenderness
  • Heat and comfort vary by area and individual sensitivity
  • Burn, altered sensation or unwanted contour response are possible
  • Eye history and electrical implants require specific screening

Rejuran and biostimulators

  • Temporary bumps, redness, swelling, bruising or tenderness
  • Infection, prolonged inflammation, nodules or unwanted contour
  • Not every biostimulatory material can be simply dissolved
  • Placement close to the eye needs product-specific judgement

Volume treatment and filler

Possible problems include persistent oedema, lumps, asymmetry, blue-grey colour, migration and infection. Accidental injection into or compression of a blood vessel can damage skin; facial filler has also been associated with rare, time-critical vision loss and stroke.

Previous treatment matters

Tell the clinician about every previous under-eye or cheek injection, laser, energy treatment or surgery—even if it was years ago. Residual product, altered tissue and a history of swelling or complications can change the safest next step.

Seek immediate help after an injectable procedure for severe or increasing pain, blanching, mottled or dusky skin, unusual coolness, a spreading colour change, new visual disturbance, eyelid droop, weakness or a severe sudden headache. Do not wait for a routine review.
What to expect

A useful under-eye consultation has four parts

Step 1

Define the concern

Review the eye area in different lighting and separate hollowing, pigment, vessels, texture and bags.

Step 2

Assess suitability

Consider lid tone, cheek support, skin thickness, fluid tendency, previous treatment and medical history.

Step 3

Compare alternatives

Discuss no treatment, injectable, skin-quality, device and surgical pathways with their different limits.

Step 4

Plan review

Cover expected recovery, warning signs, review timing and whether a staged approach is more appropriate.

Realistic expectations

Results, downtime and cost

What may improve

A suitable treatment may soften a hollow, reduce a contour shadow, improve fine texture or make the lower eyelid-to-cheek transition look less abrupt. It may not remove every dark circle or make normal skin texture disappear.

Downtime

Recovery depends on the method. Injectable swelling and bruising can be socially noticeable; laser or surgery has a different healing pattern. The area may look uneven before it looks settled, and delayed swelling is possible.

Treatment cost

Cost depends on the diagnosis, product or device, treatment area, number of sessions and whether surgery is more suitable. A quote should follow assessment and explain what review or staged care is included.

Common questions

Under-eye rejuvenation FAQs

Which under-eye treatment is best for a natural result?
The best starting point depends on the cause. Thermage FLX Eye may suit selected fine lines and early laxity, Rejuran i may suit delicate crepey skin, and a biostimulator may be discussed for broader collagen or tissue support. Pigment, true hollowness, fluid and prominent eye bags need different pathways. A natural result comes from matching the treatment to the tissue rather than choosing by product popularity.
What can Thermage FLX Eye improve?
Thermage FLX Eye may be considered for selected upper- or lower-eyelid fine wrinkles, crepey skin and early laxity. It uses non-invasive monopolar radiofrequency with a dedicated eye tip and does not add volume. It will not remove pigment, fill a deep tear trough or replace surgery for significant excess skin or eye bags.
What is Rejuran i used for under the eyes?
Rejuran i is designed for delicate periocular skin and is generally discussed for fine crepiness, texture and skin resilience rather than deeper volume replacement. Small injection bumps, redness, swelling and bruising can occur, and improvement is gradual rather than instant.
Is a biostimulator suitable for the under-eye area?
It may be part of a selected under-eye or broader facial plan, but “biostimulator” covers products with different behaviours, risks and reversibility. Not every material is suitable for direct placement beneath thin lower-eyelid skin. Product choice, treatment plane, anatomy and the desired type of support need individual assessment.
Can Thermage FLX Eye and Rejuran be combined?
Sometimes. Thermage FLX Eye and Rejuran work differently, so a staged combination may be considered when laxity and skin quality both contribute. Combining treatments is useful only when each has a clear role; timing, recovery and response should be reviewed rather than following an automatic package.
What causes tear trough hollowing?
The groove can reflect inherited anatomy, changes in bone and soft-tissue support, cheek volume, ligament structure and skin quality. It may be visible from a young age or become more noticeable over time.
Can tear trough filler remove dark circles?
Only when shadow from a hollow is an important part of the darkness. It does not remove brown pigment or visible vessels, and it may not help darkness caused by thin skin. Mixed dark circles often need more than one strategy.
Who may not be suitable for under-eye filler?
Filler may be a poor fit when prominent bags, malar oedema, significant lower-lid laxity, very thin skin, active infection, certain medical risks or previous problematic filler are present. Anatomy and expectations also influence suitability.
Can filler make eye bags look worse?
Yes. Product can add heaviness or retain fluid in an area that is already puffy. A patient whose main concern is protruding fat or fluid may benefit more from a different pathway, including surgical assessment.
What are the main tear trough filler risks?
Common effects include swelling and bruising. Other risks include lumps, asymmetry, blue-grey colour, persistent oedema, migration, infection and delayed inflammatory reactions. Rare vascular occlusion can damage skin, and facial filler has been associated with rare vision-threatening events.
Can under-eye filler be dissolved?
Hyaluronic-acid filler can often be broken down with hyaluronidase. Dissolving has its own risks, may require more than one session and does not guarantee that every contour or swelling concern will resolve immediately.
Is Rejuran or polynucleotide treatment the same as filler?
No. Polynucleotide treatment is generally discussed for skin quality, texture or fine crepiness rather than replacing structural volume. Evidence is developing, but current reviews describe small and variable studies and limited agreement on optimal use.
Can laser or tightening treatment improve the under-eyes?
Selected technologies may help pigment, fine texture or mild laxity, but one device does not treat every cause. Skin tone, eye health, target tissue, downtime and the need for appropriate eye protection all affect suitability.
When is lower-eyelid surgery more appropriate?
Surgical assessment may be more useful when protruding fat bags, significant skin excess or lower-lid laxity is the dominant concern. Surgery can also address anatomy that cannot be corrected safely by adding volume.
How long does under-eye treatment last?
Longevity varies by treatment, anatomy, metabolism and tissue response. Filler may persist for a prolonged and unpredictable period in the tear trough; skin-quality treatments may require a course or maintenance; surgery still does not stop future ageing.
How much downtime should I allow?
Plan for the possibility of visible swelling or bruising after injections. Polynucleotide injections can leave temporary bumps, while laser and surgery have their own recovery patterns. Personal and work commitments should be considered before scheduling.
Can I have treatment while pregnant or breastfeeding?
Elective injectable, laser and device treatments are commonly deferred during pregnancy, and some remain unsuitable while breastfeeding because safety evidence is limited. Tell the clinic before booking so timing can be discussed appropriately.
Your next step

Find the most natural path for your eyes

Bring the concern—not a treatment decision. MA360 can assess your eyelid skin, hollowing, pigment, fluid tendency and previous treatment, then compare Thermage FLX Eye, Rejuran, biostimulator care and other suitable options with you.

Doctor-personalised consultation: $100 fee, redeemable towards suitable same-day treatment. Suitability and same-day treatment are not guaranteed.

Book an under-eye consultation Call 1300 338 307
Medical Aesthetics 360

Under-eye treatment in Sydney: Chatswood and Hurstville

Chatswood

A North Shore clinic for tear trough, dark-circle, eye-bag and lower-eyelid assessment.

Hurstville

A southern Sydney clinic offering the same diagnosis-led approach to under-eye planning.

Explore related care

This information is general and does not replace an individual medical assessment. Treatment suitability, risks, recovery and results vary between patients.