Polynucleotides vs Tear Trough Filler - Which Is Right for Your Under Eyes?
- Skin Lab Medispa
- 6 days ago
- 5 min read
The under-eye area is one of the most searched aesthetic concerns in the UK, and one of the most frequently mistreated. For years, tear trough filler has been the default answer to almost every under-eye complaint. Dark circles? Tear trough filler. Hollowing? Tear trough filler. Fine lines and crepey skin? Tear trough filler.
The problem is that tear trough filler is the right answer for only one of those concerns, and the wrong answer for the other two. Getting this wrong produces results that look puffy, unnatural, and worse than the original problem. Getting it right requires an honest clinical assessment of what is actually causing the under-eye appearance, not a default booking.
At Skin Lab Medispa in Marylebone and Old Street, under-eye assessment is one of the consultations we take most seriously. The treatment we recommend depends entirely on the specific cause of each patient's under-eye concern. Here is how we approach that decision, and how you can use this guide to understand which treatment is likely right for you.
Understanding What Is Actually Causing Your Under-Eye Concern
Before comparing treatments, it is worth understanding that most under-eye concerns fall into one of three categories, and each has a different optimal treatment.
Volume loss and hollowing is caused by fat pad depletion beneath the eye, which creates a shadow that reads as dark circles and makes the face look tired regardless of sleep. This is a structural problem and tear trough filler, placed correctly by an experienced practitioner, addresses it directly by restoring the volume that has been lost.
Skin quality deterioration is caused by collagen loss, thinning of the skin, and reduced elasticity in the periorbital area. The skin around the eye is the thinnest on the entire face and loses collagen faster than anywhere else. When this happens the skin becomes crepey, fine lines appear, and dark shadows form not because of volume loss but because the skin itself is no longer healthy enough to reflect light evenly. This is a skin quality problem and polynucleotides address it directly. Filler placed into thin, poor-quality skin will not look natural, it will look puffy and will potentially worsen the appearance.
Pigmentation is caused by melanin deposits in the skin surface, true discolouration that neither filler nor polynucleotides will resolve. This requires a different approach entirely, usually topical treatments, peels, or laser.
Most patients experiencing under-eye concerns have a combination of the first two, some volume loss and some skin quality deterioration. Understanding the ratio between the two is what determines the most appropriate treatment approach.
Tear Trough Filler -When It Is the Right Answer
Tear trough filler is the right answer when hollowing is the primary cause of the under-eye appearance and the skin quality in the area is reasonably good, meaning it is not significantly thin, crepey, or loose.
When placed correctly by a practitioner with specific experience in this area, tear trough filler produces an immediate improvement in hollowing that can be genuinely transformative. The shadow disappears. The face looks rested. The result is visible from the day of treatment and typically lasts 9 to 18 months.
The risks are real however. The under-eye area has complex vascularity and very thin skin. Incorrect placement, too superficial, too much product, the wrong product for the skin type, produces a bluish discolouration called the Tyndall effect, or a puffy, swollen appearance that is difficult and expensive to reverse. These complications are not rare. They are one of the most common aesthetic complications we see at Skin Lab Medispa, patients who have had tear trough filler elsewhere and are unhappy with the result.
Tear trough filler from £350 at Skin Lab Medispa. Performed exclusively by our senior medical team with specific periorbital experience.
Polynucleotides for Under Eyes - When They Are the Better Answer
Polynucleotides are the right answer when skin quality is the primary issue, when the under-eye skin is thin, crepey, or showing fine lines, and when the hollowing is mild rather than significant.
Ameela Eye and Rejuran I are our two specialist periorbital polynucleotide treatments at Skin Lab Medispa, both specifically formulated for the delicate skin surrounding the eye rather than adapted from general face treatments.
Polynucleotides work by stimulating your skin's own fibroblast cells to produce collagen, improve skin density, restore elasticity, and thicken the periorbital skin from within. The results develop gradually over 6 to 8 weeks and continue improving for several months after completing a course of three sessions. The skin becomes genuinely healthier, not just temporarily fuller.
For patients with thin, poor-quality under-eye skin, polynucleotides consistently produce a more natural-looking, more lasting result than filler, because they address the actual cause of the appearance rather than masking it with volume.
Ameela Eye from £320 at Skin Lab Medispa. Rejuran I from £350. Available at our Marylebone and Old Street clinics.
When to Combine Both Treatments
For patients with both meaningful hollowing and compromised skin quality, which is common in patients in their late thirties and forties, the most comprehensive approach is to use both treatments in sequence.
Our recommended protocol at Skin Lab Medispa for patients with combined concerns: complete a course of polynucleotide treatment first to improve skin quality and thickness. This improves the foundation into which any subsequent filler is placed, produces a more natural result from the filler, and reduces the risk of complications. Once the skin quality has improved, assess whether filler is still needed for remaining hollowing.
In many cases the polynucleotide course alone resolves the under-eye appearance sufficiently that filler becomes unnecessary. In cases where hollowing remains after the polynucleotide course, a small amount of filler placed into higher quality skin produces a significantly better result than filler placed into poor-quality skin from the start.
How to Know Which Treatment Is Right for You
The honest answer is that this decision requires an in-person assessment. Photographs and self-diagnosis are unreliable for under-eye concerns because the lighting, angle, and individual anatomy all affect how the concern appears and what is actually causing it.
What we always assess at consultation is the skin thickness and quality in the periorbital area, the degree and location of any hollowing, the presence of pigmentation or puffiness, and the patient's medical history and previous treatments in the area.
Complimentary consultations are available at both our Marylebone clinic at Light Centre, 4 Baker Street W1H 6AZ and our Old Street clinic at The Light Centre, 5 Singer Street EC2A 4BQ. We will give you an honest assessment of which treatment or combination of treatments is genuinely right for your specific under-eye concern - and we will tell you clearly if treatment is not appropriate.
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