GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Volume / Contour · Tear trough / infraorbital hollow

HA filler crosslinked evidence for Tear trough / infraorbital hollow

B 58.4 / 100 Supported 14 RCT/meta · 11 clinical/observational · 35 case · 135 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2021 Last 5 years 53% Positive results 33% Negative results 3 Korea/Asia 11

Known in Korea as

필러라풀렌리쥬필리즈네미라콜쥬비덤뉴라미스레스틸렌리쥬비엘바디필러

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 A Prospective, Randomized, Active-Controlled, Evaluator-Blinded, Noninferiority Clinical Trial Examining a Non-Cross-Linked Bovine-Derived Type I/III Collagen Filler Combined with Hyaluronic Acid for Periocular Rejuvenation. Aesthetic plastic surgery · 2025 · PMID 41345306

Abstract summary (English) BACKGROUND: The use of dermal fillers for periocular rejuvenation is common, with hyaluronic acid (HA) being the most popular agent. However, the use of HA in the delicate tear trough region may induce the Tyndall effect, resulting in undesirable bluish discoloration of the lower eyelid. The main drawback of collagen monotherapy is its relatively short effective duration.

Journal Article, Randomized Controlled Trial, Equivalence Trial

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tier1 Formulation and clinical evaluation of hyaluronic acid nanogel in treatment of tear trough: nano-flipping from injectable fillers to topical nanofillers. Pharmaceutical development and technology · 2025 · PMID 39873185

Abstract summary (English) Tear trough deformity (TTD) is a significant cosmetic concern, with current treatments relying primarily on invasive injectable fillers, which are costly and carry risks of complications. Despite the widespread use of hyaluronic acid (HA) in cosmetic applications, its poor dermal permeation has limited the development of effective topical fillers for TTD. This study aim to develop and evaluate a novel hyaluronic...

Journal Article, Randomized Controlled Trial

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tier1 A Prospective, Multicenter, Evaluator-Blind, Randomized, Controlled Study of Belotero Balance (+), a Hyaluronic Acid Filler With Lidocaine, for Correction of Infraorbital Hollowing in Adults. Aesthetic surgery journal · 2024 · PMID 38377391

Abstract summary (English) BACKGROUND: The infraorbital hollow (IOH) is a concavity that interrupts the smooth transition between the lower eyelid and the cheek, resulting in a fatigued and aged appearance. Injectable fillers may be utilized to correct volume deficit in the under-eye area, restoring a more youthful appearance. OBJECTIVES: The objective was to demonstrate the effectiveness and safety of a cohesive polydensified matrix (CPM)...

Journal Article, Randomized Controlled Trial, Multicenter Study, Research Support, Non-U.S. Gov't

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tier1 Prospective comparative clinical study: Efficacy evaluation of collagen combined with hyaluronic acid injections for tear trough deformity. Journal of cosmetic dermatology · 2024 · PMID 38299745

Abstract summary (English) BACKGROUND: Tear trough filling is a popular facial rejuvenation procedure, and hyaluronic acid is typically used as the filler of choice. However, Tyndall's phenomenon, a common complication following hyaluronic acid injection, can occur, leading to skin discoloration of the lower eyelid. AIMS: This single-center, prospective, comparative clinical study aimed to evaluate the efficacy of collagen and hyaluronic acid...

Journal Article, Randomized Controlled Trial, Comparative Study

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tier1 The Efficacy and Safety of Hyaluronic Acid Injection in Tear Trough Deformity: A Systematic Review and Meta-analysis. Aesthetic plastic surgery · 2023 · PMID 37684413

Abstract summary (English) BACKGROUND: Hyaluronic acid (HA) injection is an effective method to correct tear trough deformity. Nevertheless, the quantitative data of cosmetic results and complications of HA injection in tear troughs remained unemployed. The purpose of this meta-analysis was to synthesize the current quantitative data on the aesthetic outcomes and adverse effects of tear trough deformity correction with HA injection.

Journal Article, Meta-Analysis, Systematic Review

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tier1 Safety of infraorbital hyaluronic acid injections: Outcomes of a meta-analysis on prospective clinical trials. Journal of cosmetic dermatology · 2023 · PMID 37424173

Abstract summary (English) BACKGROUND: Hollowing of the infraorbital region represents a common concern among aesthetic patients. In the past decade, an increasing number of patients have resorted to noninvasive aesthetic procedures to treat these concerns. The objective of this study was to evaluate the safety profile of infraorbital hyaluronic acid injections for aesthetic rejuvenation.

Systematic Review, Meta-Analysis, Journal Article

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tier1 Tear Trough Filler Techniques Utilizing Hyaluronic Acid: A Systematic Review. Plastic and reconstructive surgery · 2022 · PMID 35259144

Abstract summary (English) BACKGROUND: Hyaluronic acid soft-tissue augmentation fillers are commonly injected into multiple areas of the face, including the tear trough. Despite well-documented risks, there is no standardized, evidence-based approach to inject filler in this area, be it using a hypodermic needle or a microcannula. The authors, therefore, sought to establish a preference between the two methods to facilitate progression toward...

Journal Article, Systematic Review

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tier1 Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review. Facial plastic surgery : FPS · 2021 · PMID 34666405

Abstract summary (English) Tear trough deformity is a popular target for the treatment with filler injections. The side effects are generally mild and transient. However, delayed complications may occur.

Journal Article, Systematic Review

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tier1 Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. Facial plastic surgery : FPS · 2021 · PMID 34192769

Abstract summary (English) There is significant variation in treatment parameters when treating the infraorbital region. Thorough knowledge of these pertinent factors, choice of the optimal filling material, and proper understanding of the anatomy of this unforgiving region will contribute to a safe, effective, and natural result. We aim to conduct a systematic review of published literature related to soft tissue fillers of the tear trough...

Journal Article, Systematic Review

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tier1 A Prospective, Multicenter, Single-Blind, Randomized, Controlled Study of VYC-15L, a Hyaluronic Acid Filler, in Adults for Correction of Infraorbital Hollowing. Aesthetic surgery journal · 2021 · PMID 34351386

Abstract summary (English) BACKGROUND: Rejuvenation of the under-eye area is a popular facial aesthetic treatment option. OBJECTIVES: This study evaluated the safety and effectiveness of VYC-15L for the correction of moderate or severe infraorbital hollowing. METHODS: This was a randomized, controlled, single-blind study with a primary endpoint defined as the proportion of participants with ≥1-grade improvement at Month 3 assessed by an...

Journal Article, Multicenter Study, Randomized Controlled Trial

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