Hollow cheeks, tear troughs and lost volume
Hollow or sunken cheeks and hollows under the eyes usually come from changes beneath the skin: the deep fat pads of the face shrink and parts of the bone slowly recede, so the skin above loses its support. Hyaluronic-acid filler can put back some of that support where it was lost, and biostimulators can help rebuild it gradually from your own collagen. Under the eyes, filler suits a true hollow but not puffy bags or pigment, so a doctor looks first.
At a glance
- Who you’ll see
-
- Dr. Svetlana Tagaeva Medical Director
- Dr. Olga Ibrakova Cosmetology
- Dr. Daria Banina Cosmetology
- Where
- CREAMÉ, 350 Al Wasl Road, Jumeirah 1, Dubai
- What may help
-
- Dermal fillers Hyaluronic-acid filler
- Biostimulators Collagen-stimulating injections
- Skin boosters Hydrating micro-injections
- Polynucleotides and PRP Regenerative injections
- Filler dissolving Filler correction with hyaluronidase
The short answer
Lost volume is answered with structure, not size. Fillers, biostimulators and skin boosters each do a different job, and the plan favours the reversible and the gradual, so you still look like you.
Probably not that: Overfilled faces are rarely one bold treatment; they are many small ones added without a plan. We would rather do less.
What it is, and why it happens
Volume loss is a change in the layers under the skin. The fat of the face sits in separate compartments, and with age the deep ones tend to shrink, so the fat above them loses its support and settles lower. The bone changes too: parts of the rim of the eye socket and the upper jaw beneath the cheeks recede. Together these show as a flatter mid-cheek, a groove running down from the inner corner of the eye (the tear trough) and deeper folds from the nose to the corners of the mouth, which often reflect lost support above them rather than a problem in the fold itself.
Age is only one cause. A tear trough can come with the shape of the cheekbone, and young people have it too. Losing a lot of weight, especially quickly, as can happen with weight-loss medicines, thins the fat of the cheeks, the temples and the area around the eyes. And some of what looks like lost volume is something else: skin that has loosened and dropped, puffy bags under the eyes, or dark circles from pigment.
For choosing care, three things matter: where the volume has gone, the quality of the skin over it, and whether the change is volume at all. A defined hollow under reasonably thick, smooth skin suits filler well; thin, finely wrinkled skin may need its quality improved first. Skin that has dropped rather than hollowed is laxity, which needs a different plan.
What may help
Dermal fillers · Hyaluronic-acid filler
Hyaluronic-acid filler is the main tool: a soft gel placed deep in the cheeks, temples or chin, and in small amounts in the tear trough, usually in one session with a small top-up a few weeks later if needed; the change usually shows on the day, under some swelling, and fades over six to eighteen months. Biostimulators suit broader, gradual loss, such as after weight loss: biodegradable particles prompt your own collagen over two to three months, typically over one to four sessions a few weeks apart, and last around two years, but they cannot simply be dissolved, so the physician decides carefully whom they suit. Where the skin over a hollow is thin and crepey, skin boosters or regenerative injections improve its quality rather than fill it. Swelling, tenderness and bruising are common and usually settle within one to two weeks; less often there are lumps or, under the eyes, a bluish tint or puffiness when gel sits too shallow or there is too much of it. A blocked blood vessel is rare but serious, which is why the enzyme that dissolves hyaluronic acid is always on our shelf.
What to be careful with
Where filler goes matters as much as how much. Restoring support in the deep layers tends to look more natural than layering gel near the surface, and small amounts are easier to judge and to correct. Under the eyes especially, hyaluronic acid holds water, so too much can look puffy, and gel placed too shallow can show through as a bluish tint.
Filler is not the answer to everything that looks hollow. Puffy bags under the eyes, loose eyelid skin and swelling at the top of the cheek tend to look worse with it, and it does not lighten dark circles caused by pigment. If filler isn't right for you, the doctor will say so and explain what fits instead.
If your weight is still changing, volume is usually planned once it has settled: filler or biostimulators added while weight is falling can leave the face looking overfilled later. If you take weight-loss medicines, the plan is reviewed as you go.
What matters in Dubai
In a city of many backgrounds there is no single ideal of a full face, and fullness that suits one face can look heavy on another. Ageing differs too: the facial bones change at a different rate and to a different extent in men and women. So the plan starts from your features and what you want to keep, not from a template or a photograph of someone else.
Plan a quiet day after filler, as hard exercise, saunas and hot yoga can add to swelling and bruising in the first day. If you are fasting in Ramadan, an appointment after iftar may suit you better, and if you spend the summer away, book early enough to be seen again, and adjusted if needed, before you fly.
When to see a doctor first
Hollowing is a medical question before a cosmetic one when it comes on quickly without a clear reason, affects one side of the face only, or comes with weight loss you can't explain, tiredness or other changes in your health. Hollowing on one side that begins in childhood or the teenage years, sometimes with an indented strip of skin, headaches or seizures, can be a rare condition related to scleroderma, and it needs a specialist's diagnosis before anything is injected.
Filler is a medical procedure, so it starts with a doctor's questions: cold sores, allergies, a bleeding problem or blood-thinning medicines (never stop a prescribed one without asking the doctor who prescribed it), pregnancy or breastfeeding, recent illness or dental work, and every filler you have had before, especially any that does not dissolve. After filler, contact us straight away, or get urgent medical care, if pain grows instead of easing, the skin turns pale, grey, blue or blotchy, or your vision changes: these are rare signs of a blocked blood vessel, and they are treated without delay. Dr. Svetlana Tagaeva, the Medical Director, leads the clinic's medical work, injectables included, and Dr. Olga Ibrakova's work includes contouring with filler and biostimulators.
Questions people ask
Can filler fix hollows under the eyes?
Often it can soften them, when the shadow comes from a true hollow and the skin over it is reasonably thick. In a pooled analysis of 31 studies of filler for tear troughs, about nine in ten people were satisfied; swelling and bruising each affected about one in five, lumps about one in twenty and a bluish tint about one in a hundred. It does not help puffy bags or pigment.
How long does filler last in the cheeks and under the eyes?
Usually six to eighteen months, depending on the gel and the area; one review describes filler in the tear trough lasting up to about 12 to 15 months. It fades gradually, and you can top it up or let it go.
What is the difference between filler and biostimulators?
Filler adds volume where it is placed, shows on the day and can be dissolved. Biostimulators prompt your own collagen, so the change builds over two to three months; in a review of trials of one of them, poly-L-lactic acid, the effect lasted at least 25 months, though the reviewers rated the evidence as low quality. Some plans use both: filler for a defined hollow, biostimulators for broader loss.
Can filler be dissolved if I don't like it?
Hyaluronic-acid filler can: an enzyme dissolves it, usually within a day or two, sometimes over more than one session. The enzyme can rarely cause an allergic reaction, so a small skin test usually comes first unless the situation is urgent. Biostimulators cannot be dissolved this way.
I'm losing weight with weight-loss injections. When should I treat hollows?
Usually once your weight has settled. Volume added while weight is still falling can look like too much later, so the doctor may suggest waiting, reviewing as you go, and treating only the areas that stay hollow.
When should I have filler before a wedding or Eid?
At least two weeks before, and a month is better: swelling settles over the first days, and the result is judged at two to four weeks, which leaves time for a small adjustment. Biostimulators take two to three months to show, so start them well ahead.
How do I choose a skin clinic or specialist for tear trough filler?
Look less at what the clinic is called and more at who injects: a doctor with a DHA licence who examines you first and will say no when the shadow is bags, puffiness or pigment rather than a hollow. Ask which filler is used: hyaluronic acid can be dissolved, and the enzyme that dissolves it should be on the shelf. Expect small amounts placed deep, a review at two to four weeks, and clear advice on what to do if pain grows or your skin colour or vision changes.
What causes volume loss in the face, such as hollow cheeks after weight loss, and what helps?
With age, the deep fat pads of the face tend to shrink and parts of the bone recede, so the skin loses support; losing a lot of weight, especially quickly, thins the fat of the cheeks, temples and around the eyes. What may help depends on the pattern: hyaluronic-acid filler for a defined hollow, biostimulators for broader loss such as after weight loss, once your weight has settled, and skin boosters or regenerative injections where the skin over a hollow is thin. Skin that has dropped needs another plan.
Where can I get tear trough filler in Dubai, and which doctor does it?
At CREAMÉ, 350 Al Wasl Road, Jumeirah 1, a doctor does tear trough filler after a consultation, and the doctor who assesses you is the one who treats you. Dr. Daria Banina's facial contouring includes tear troughs, and Dr. Olga Ibrakova's work includes contouring with filler; Dr. Svetlana Tagaeva, the Medical Director, leads the clinic's medical work. The consultation comes first because filler suits a true hollow, not puffy bags or pigment.
Is tear trough filler done for men, and do the results or the cost differ?
Yes. The plan starts the same way for men and women: a doctor checks that the shadow is a true hollow, not bags or pigment. The facial bones change at a different rate and to a different extent in men and women, so the amount and placement follow your own features; the aim is to look rested, not different. We don't publish prices: the cost depends on the area and the number of sessions, set at the consultation, and you know the full plan and cost before you start.
When do tear trough filler results show, how many sessions will I need, and how often is it repeated?
The change usually shows on the day, under some swelling, and the result is judged at two to four weeks, when a small top-up can be added if needed. So it is usually one session, sometimes with that top-up. After that the gel fades gradually over many months; a repeat is planned when you see it fading, and only if the area still needs it, rather than on a fixed schedule.
What should I expect after tear trough filler: pain, downtime, recovery time and aftercare, day by day?
Expect some tenderness and a quiet day; downtime is usually short, though swelling and sometimes bruising can take one to two weeks to settle. Ice and the local anaesthetic many fillers contain can make the injections more comfortable. On the day, cool the area with ice and skip hard exercise, saunas, hot yoga and extreme heat or cold; for a week, don't rub or massage the area and have no facials or other treatments there. The result is reviewed at two to four weeks.
What are the side effects and risks of dermal filler in the tear trough, and can a bad result be fixed?
Swelling and bruising are most common, and redness affects about one in fourteen people in pooled studies. Less often there are lumps, puffiness from too much gel that comes and goes with salt or allergies, or a bluish tint from gel placed too shallow; dissolving the gel usually corrects these. A bruise can occasionally leave a brown stain that takes months to fade, more often in darker skin. Infection is very rare. A blocked blood vessel is rare but serious, is treated at once, and very rarely affects sight.
Tear trough filler vs polynucleotides, PRP or anti-wrinkle injections: which suits under-eye hollows or wrinkles?
It depends on what you see. Filler suits a true hollow: it adds support where it is placed and usually shows on the day. Polynucleotides and platelet-rich plasma (PRP) do not fill; they signal the skin to repair, so they can suit thin, crepey skin under the eyes, with results building over a course. Anti-wrinkle injections soften lines that come with expression, such as crow's feet, and do nothing for a hollow. Where the skin is thin, the plan may improve it first and add a little filler later.
Hollow cheeks vs no hollows: are full cheeks better, and should I fill mine or not?
Neither is better in itself: there is no single ideal of a full face, and fullness that suits one face can look heavy on another. What tends to make a face look tired is a change, such as a flatter mid-cheek with a deeper groove under the eye, rather than a shape you have always had. So treat it only if a change bothers you. Hollowing that comes on quickly without a clear reason, or on one side only, is a question for a doctor first.
Cheek filler or tear trough filler: which do I need?
Tear trough filler and under-eye filler usually mean the same thing: a small amount of hyaluronic-acid filler placed deep along the groove below the eye. Cheek filler restores support deep in the mid-cheek. The two are linked: as the deep fat of the cheek shrinks, the groove above it tends to lengthen, and support placed deep in the cheek can soften it. So the doctor may start with the cheek and then judge how much, if any, the tear trough still needs.
Related concerns
Sources
- Wan D, Amirlak B, Rohrich R, Davis K. The clinical importance of the fat compartments in midfacial aging. Plast Reconstr Surg Glob Open. 2013;1(9):e92.
- Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg. 2012;36(4):753–760.
- Sharad J. Dermal fillers for the treatment of tear trough deformity: a review of anatomy, treatment techniques, and their outcomes. J Cutan Aesthet Surg. 2012;5(4):229–238.
- Liu X, Gao Y, Ma J, Li J. The efficacy and safety of hyaluronic acid injection in tear trough deformity: a systematic review and meta-analysis. Aesthetic Plast Surg. 2024;48(3):478–490.
- Signori R, Barbosa AP, Cezar-dos-Santos F, et al. Efficacy and safety of poly-L-lactic acid in facial aesthetics: a systematic review. Polymers (Basel). 2024;16(18):2564.
- Signorini M, Liew S, Sundaram H, et al. Global Aesthetics Consensus: avoidance and management of complications from hyaluronic acid fillers—evidence- and opinion-based review and consensus recommendations. Plast Reconstr Surg. 2016;137(6):961e–971e.
- Bommareddy K, Fabi S, Muniz M. Aesthetic considerations for preventing and managing GLP-1 receptor agonist–related facial aging. J Clin Aesthet Dermatol. 2026;19(7):16–22.
- Tolkachjov SN, Patel NG, Tollefson MM. Progressive hemifacial atrophy: a review. Orphanet J Rare Dis. 2015;10:39.
- Kroumpouzos G, Treacy P. Hyaluronidase for dermal filler complications: review of applications and dosage recommendations. JMIR Dermatol. 2024;7:e50403.
Updated 27 October 2026