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Treating The Tear Troughs Via The Cheek

Tear trough filler is an advanced aesthetics treatment that new injectors should not attempt without proper training. However, once you are confident in your injecting skills, especially using a cannula, often you will be able to start indirectly treating the tear troughs via the cheek.

Though still a tricky and demanding treatment, this approach to the under eyes is less risky than treating the tear troughs directly and can produce lovely results. In some cases this may mean the tear trough does not need direct treatment.

Therefore, it’s a good intermediate step for new injectors. One for those who have gained confidence in treating patients with fundamental dermal filler and toxin treatments, but who are not yet ready for advanced aesthetic medicine training.

Patients love the refreshed look it gives to their appearance, making them look instantly more awake and less tired, too. They are also rewarding treatments to deliver!


Mid-face treatment to revolumise the tear troughs

Dr Raquel Amado is a senior clinical trainer at Harley Academy. She is also an experienced facial aesthetics and skin ageing specialist who runs her own growing practice in Kent. She talked us through the technique for treating the tear troughs via the cheek…

How do you treat the tear troughs via the cheek?

“You treat the cheek apex, the lateral zygoma and the medial cheek fat that supports the tear trough region. It’s called a mid-face treatment.”

Who is this type of under eye treatment suitable/not suitable for?

“Tear trough treatment is not suitable for patients who have malar mounds, anyone who has periorbital oedema, swelling, any bags under the eyes or excessive skin laxity. Obviously it all depends on the individual patient. Always conduct a thorough consultation prior to treatment. This includes discussing realistic expectations and alternative treatments as appropriate.”


What is the correct injection technique for treating tear troughs via the mid-face?

“When you treat the tear trough via a mid-face treatment, you’re injecting into layer four below the muscle. If you’re doing lateral zygoma, you can use superperiosteal boluses or you can go into the prezygomatic space with a cannula. Medial fat restoration is always layer four with a cannula to avoid damage to the infraorbital neurovasculature. Use linear threads or a fanning technique.”

How can injectors learn this technique?

“Mid-face treatments can be covered to a certain extent during your Level 7 mentoring. This would include the basic techniques. Dedicated, in-depth training on under-eye filler treatments are available during our advanced Tear Trough Masterclass sessions.”

Find out more about mid-face treatment training

If you are a licensed doctor, dentist, nurse or midwife and have a particular aesthetic treatment or competency you’d like to learn or improve, we can help. In addition to the training course information here on our website, you can book a call with Deneal Basi, our head of student recruitment. 

Deneal knows our courses inside out and will be able to guide you through your options to find the perfect fit. Whether you’re starting from scratch or are a medical aesthetics practitioner looking to hone your skills in a specific area, he’ll set out your best matches. He can also advise you on our full offering and the payment options available for future-proofing your career by becoming #HarleyTrained.