Following our Trikwan Doctors Zoya Diwan and Sanjay Trikha’s published paper with the AAMG detailing the success of using the relatively new cannula technique for Tear Trough filler, we thought we’d expand on a few more facts and figures about one of our most requested treatments. At Trikwan Aesthetics our goal is to ensure all…

Following our Trikwan Doctors Zoya Diwan and Sanjay Trikha’s published paper with the AAMG detailing the success of using the relatively new cannula technique for Tear Trough filler, we thought we’d expand on a few more facts and figures about one of our most requested treatments. At Trikwan Aesthetics our goal is to ensure all of our patients leave our online and in-clinic spaces feeling better educated and empowered to make informed decisions, so if you have been considering Tear Trough fillers and are looking for the research behind the treatment, read on to find out our top 5 facts and stats:

1. Pain during treatment – Should it hurt?

Tear trough filler treatment should not be painful! Any pain experienced is routinely reported to be minimal, with the majority of people reporting experiencing some discomfort during the treatment. In fact, many patients report Tear Trough treatment to be less painful than they expected, if at all. Having said that, if, during your injection, you do feel any extreme pain, be sure to make your practitioner aware immediately and they should cease the procedure straight away and assess you to ensure that you haven’t experienced an adverse side effect.

2. Blindness as a severe complication of Tear Trough filler

Up to the year of 2015, only 98 cases of blindness after dermal filler in the face had been reported globally. Although there are some studies that predict that the actual number, including unreported cases, could be up to 300-400. Nevertheless, while blindness is an incredibly serious complication of filler injection, this also makes it one of the rarest complications experienced by patients globally. Furthermore, and perhaps surprisingly to many, the majority of cases that have resulted in blindness have occurred due to injection of dermal filler in the nose, frown lines and nasolabial fold, rather than in the Tear Trough region – making this complication even rarer for this particular treatment. Ultimately the best way to avoid any rare complication of your filler treatment is to ensure you thoroughly research your practitioner’s background, knowledge and experience. Are they medically qualified? Where did they train? How long have they been performing this treatment? Have they ever had a serious complication before? Can they answer all your questions clearly and thoroughly? – Make sure you find the answers to these questions before you continue with any treatment plan they propose.

3. The cannula technique is safer and causes less complications than the needle technique for Tear Trough filler treatments.

The AAMG’s recent publication in the prestigious Journal of Plastic and Reconstructive Surgery concluded that the use of a cannula (the technique used here at Trikwan) for placement of dermal filler in the tear trough region is safer and produces far fewer complications in comparison with reported treatment outcomes using the traditional needle method. This is due to the fact that the cannula avoids the use of sharp needles in the complex under-eye area, which could damage the delicate structures and blood vessels found here. Any complications experienced post-treatment using the cannula method were minor bruising and swelling which, in all patients, resolved within 1 month of treatment.

4. Teosyal Puresense Redensity II is currently the only product formulated specifically for use in the Tear Trough region, in Europe.

Teosyal Puresense Redensity II is a hyaluronic acid filler manufactured by Teoxane and is the product we use at Trikwan Aesthetics for our under-eye filler treatments. This filler is formulated as having 70% cross-linked HA and 30% non-cross linked HA, which is suitable for filling this area and makes the filler durable, meaning results will last up to 12 months. Due to the way it is formulated this form of dermal filler retains very little water, so that it replaces lost volume without making the eyes look puffy. The gel contains 15 added ingredients, including a combination of vitamins, minerals and amino acids which maximise the rejuvenation of the skin of the under-eye. 3 mains anti-oxidants (glutathione, N-acetyl-L-cysteine and alphalipoic acid) are included specifically to brighten the under eye area.

5. The 4 Levels of Tear Trough Deformity

LEVEL 1 – SKIN: Loss of volume in the skin, reduction in collagen during the ageing process, and distortion and reduced elasticity of the elastin fibres within the skin all contribute to under eye hollows.
LEVEL 2 – FAT: The fat pads around the eye thin and descend down the face to contribute to a decrease in the volume around the eyes.
LEVEL 3 – MUSCULATURE: The Orbicularis Oculi muscle (the circular muscle around your eye) both contributes to the development of wrinkles in the skin of the under eye, and to the deepening of tear troughs as it becomes laxer with age.
LEVEL 4 – BONE: As we age the bottom edge of the eye socket bone starts to recede, therefore displacing all the structures that lie above it and helping to cause the formation of a tear trough deformity.


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The most professional, down to earth, friendly aestheticians I could of wished for. I was pretty hesitant to get anything done to my face as I didn’t want the typical over done ‘instagram’ look.

I wasn’t pressured into doing anything outright and was told about all the possible options I could take and the differences between them and what would suit me. I have had two sessions and over that time, I am beyond pleased with the the results! Dr Zoya has masterfully kept my face the same but just enhanced and corrected things certain in places.

Would definitely recommend if you want a realistic, subtle, natural yet major improvement to any problem areas.


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Visited Trikwan today in London from NYC and it was such a pleasure. Tammy the office manager was so super helpful and nice, she made the whole booking process very easy and was happy to answer any/ all questions. Both Drs were amazing, friendly and professional. They really took the time to work with me and discuss all my needs and wants. I highly recommend this establishment and will be going back! A+