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The tear trough is the hollow that runs from the inner corner of the eye down across the top of the cheek. As it deepens it casts a shadow, which is why people describe looking tired when they have slept perfectly well.
Hyaluronic acid filler placed in that hollow restores the volume that has been lost, which softens the shadow.
At Hannah Clarke Advanced Skin and Beauty in Rainford, it is treated by Gemma Fletcher, a Registered Nurse and Independent Nurse Prescriber with over five years injecting daily.
This is one of the most technically demanding areas on the face, and it is not a treatment to shop for on price.
Gemma will often assess cheek filler first, because mid-face support is frequently what the hollow is actually asking for. See dermal fillers in St Helens for the full approach.
Every area of the face carries some risk. The under eye carries more, and the margin for error is smaller.
The skin here is the thinnest on the face and the anatomy underneath is unforgiving. Product placed in the wrong plane, or too much of it, shows. So the questions to ask an injector treating this area are about training, experience and what happens if something goes wrong, not about price.
Gemma injects daily, holds a V300 prescribing qualification, and carries hyaluronidase in the room at every appointment so that hyaluronic acid filler can be dissolved immediately if it ever needs to be.
She is also willing to say no. If the hollowing is not the actual cause of what is bothering you, filler will not fix it, and she would rather tell you that at consultation than take the booking.
Tear trough is one of a number of areas she treats. The others are cheeks to lift and contour, chin to elongate the face and harmonise the contours, jaw for contour and structure, temples to restore volume, marionette lines, nasolabial folds, and lips and lip lines.
Most people asking about filler are really asking about safety, so here is the honest version.
Mild effects are normal. Bruising and swelling after treatment are expected rather than a problem.
Infection is uncommon and usually avoidable. The procedure is as sterile as it can be and the skin is thoroughly cleansed. Where infection does occur it generally follows aftercare being ignored, most often makeup going on the area too soon. That is why Gemma asks you not to rub or touch the area for the first four hours.
Vascular occlusion is the serious one. It is where filler blocks an artery supplying the treated area. It is rare, and in Gemma's words it is usually a problem of unsafe hands. If left unrecognised it can lead to tissue necrosis, which is what people have seen on social media and in the papers. That outcome almost always traces back to a practitioner who did not react quickly enough, or who sent the client away without properly explaining aftercare.
Gemma will not let you leave the clinic if she has any concern about occlusion. After treatment she assesses the colour of your skin and any pain you are experiencing, and she is looking at the treated area specifically before she is happy for you to go home. If a complication did occur, hyaluronic acid filler can be dissolved immediately, and beyond some bruising there would be no lasting result.
BOOK TODAYDermal filler treatments at Hannah Clarke are delivered by Gemma Fletcher.
- Registered Nurse with the Nursing and Midwifery Council.
- V300 Independent Prescribing qualification, so she consults, prescribes and administers independently.
- Trained at Northwest Aesthetics and Dr. Hennessy Aesthetics, with ongoing training.
- Over five years injecting dermal filler, performing treatments daily.
- Carries hyaluronidase, the enzyme that dissolves hyaluronic acid filler, on site at every appointment.
That last point matters more than it sounds. In her words: "I would have hyaluronidase on site at every appointment just to ensure in an emergency I would be able to treat." Not every injector can prescribe it, and not every injector has it in the room.
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