The under-eye area is where the face gives away how you feel before you say a word.
Tear trough filler at Nexus Clinic Kuala Lumpur addresses the structural cause of that shadow.
Important Clinical Note
Not every dark circle or eye bag responds to filler.
✨ Refreshed Look
Restored brightness • Natural results
Since
2001
Location
KLCC
Hours
Mon-Sat
Everything you need to know
Treatment
Soft HA filler for under-eye hollows
Session Time
20 to 30 minutes
Downtime
Minimal, 3-7 days
Results
Immediate, final at 7-14 days
Longevity
9 to 15 months
Reversible
Yes. Fully dissolvable with hyaluronidase
Volume Used
0.3 to 0.8ml per side
Suitable For
Hollow tear troughs, under-eye shadow from volume loss
Only one responds well to filler
| Type | What Causes It | What It Looks Like | Best Treatment |
|---|---|---|---|
| Hollow and Structural | Volume loss in the tear trough and orbital fat compartments. Cheek descent pulls support away from the lower eyelid. | A sunken groove or hollow beneath the eye casting a dark shadow. Face looks tired regardless of sleep. | Tear trough filler. This is the type filler was designed for |
| Pigmented (Brown) | Excess melanin production in the under-eye skin. More common in South Asian, Malay and darker-complexion patients. | Brown or tan discolouration. The skin is flat, not hollow. Shadow present even in bright light. | Pico laser, skin booster, topical brightening agents. Filler does not reduce pigment |
| Vascular (Blue/Purple) | Thin under-eye skin revealing blood vessels beneath. Worsened by dehydration, allergies, and poor sleep. | Blue or purple tint, often worst when tired or after alcohol. Skin is flat or slightly sunken. | Skin booster, Rejuran, NCTF to thicken skin quality. Filler may slightly help if hollow component present |
| Puffy Fat Herniation | Weakened orbital septum allowing fat pads to bulge forward beneath the eye | Physical puffiness or swelling, most noticeable in the morning. A visible bulge, not just a shadow. | Agnes RF, surgical blepharoplasty. Filler can worsen puffiness by adding volume on top of a fat bag |
Type
Hollow and Structural
What Causes It
Volume loss in the tear trough and orbital fat compartments. Cheek descent pulls support away from the lower eyelid.
What It Looks Like
A sunken groove or hollow beneath the eye casting a dark shadow. Face looks tired regardless of sleep.
Best Treatment
Tear trough filler. This is the type filler was designed for
Type
Pigmented (Brown)
Type
Vascular (Blue/Purple)
Type
Puffy Fat Herniation
Many patients have a combination of more than one type. A proper diagnostic assessment before treatment is essential. At Nexus Clinic KL, the doctor assesses your under-eye type at consultation and gives you an honest picture of what filler will and will not improve.
Why local patients present differently
Higher Melanin Levels
Patients of Malay, Indian and Chinese descent in Malaysia frequently have a genetic predisposition to periorbital hyperpigmentation. The under-eye skin produces more melanin in response to UV exposure and even gentle eye rubbing. This brown pigmentation is independent of the structural tear trough and does not respond to filler injections. Patients in Malaysia often have both pigmentation and structural hollowing at the same time, which requires a combined approach.
Allergic Rhinitis & Allergic Shiners
Malaysia has a high prevalence of allergic rhinitis among the population. Nasal congestion from allergies causes venous congestion around the eyes, darkening the under-eye skin from dilated blood vessels. This creates what is clinically called allergic shiners, a blue-purple discolouration that is present even in young patients. Filler does not address this vascular component. Managing the underlying allergy and using skin booster treatment to improve skin quality are the appropriate approaches for the vascular element.
Early Midface Volume Loss
As discussed in detail on the Nexus Clinic KL cheek filler page, Asian patients experience midface volume loss earlier than Western patients. As the cheek descends, it pulls support away from the lower eyelid and makes the tear trough deepen more rapidly. This is why tear trough hollowing in Malaysian patients often appears in the late twenties rather than the mid-thirties.
This is one of the most important clinical considerations in under-eye rejuvenation and one that most patients are never told before booking tear trough filler.
The tear trough deepens in part because the cheek below it has descended. When the cheek drops, the lid-cheek junction widens, the support for the lower eyelid disappears and the tear trough hollow deepens from below. In these cases, adding tear trough filler alone fills the hollow but does not address the structural reason the hollow formed. The result lasts less time than it should, requires more frequent top-ups and is less natural-looking than it would be with proper midface foundation first.
The American Society of Plastic Surgeons has noted that successful tear trough rejuvenation frequently requires addressing the midface simultaneously to provide a stable structural foundation, since the under-eye area is highly dependent on the support provided by the cheek below it.
At Nexus Clinic KL, the doctor assesses the relationship between your cheek position and your tear trough depth at consultation. Patients who need cheek support first are given a staged treatment recommendation, not simply sold tear trough filler regardless of their anatomy.
Patients with both midface volume loss and tear trough concerns often benefit from addressing cheek filler first before or alongside tear trough treatment at Nexus Clinic KL.
The Most Technically Demanding Facial Filler Area
If filler is placed too superficially, HA gel scatters light and creates a visible bluish tint under the skin. Prevented by deep placement with soft, low-hygroscopic products.
Patients with orbital rim behind the eyeball are poor candidates for tear trough filler. The doctor assesses orbital vector at consultation.
Most patients need only 0.3 to 0.8ml per side. More than 1ml per side increases risk of puffiness, Tyndall effect and migration.
At Nexus Clinic KL
Very soft, low-hygroscopic HA filler specifically formulated for superficial and periorbital placement. Integrates smoothly with tissue without water-attracting swelling.
✓ Excellent safety profile in periorbital zone
Dedicated tear trough filler containing hyaluronic acid combined with amino acids, vitamins and minerals. Designed specifically for the delicate periorbital zone.
✓ Provides both volumising and skin quality improvement
Softest product in the Juvederm range. Used for tear trough when a very subtle, light correction is needed in patients with relatively thin skin.
✓ Reduces risk of bluish Tyndall effect in extremely thin periorbital skin
According to the International Society of Aesthetic Plastic Surgery (ISAPS) 2024 Global Statistics Report, periorbital and under-eye rejuvenation treatments ranked among the top aesthetic concerns for patients aged 25 to 40 in Southeast Asia.
Step by step
Doctor assesses under-eye type, skin thickness, fat herniation, and whether cheek descent is contributing.
Product, volume and placement depth confirmed. Alternative treatments recommended if filler not appropriate.
Topical numbing applied. Blunt cannula deposits filler through a single entry point. 15-25 minutes.
Results reviewed from multiple angles. Full aftercare provided. Two-week follow-up scheduled.
Same-day results at Nexus Clinic KL
Transparent 2026 Pricing at Nexus Clinic KL
| Treatment | Product / Option | Parts / Areas | Units / Session / Duration | Normal Price RM | Selling Price RM | First Trial Price RM | Promo Price | Standard Package | Trial / Promo Notes |
|---|---|---|---|---|---|---|---|---|---|
| Tear Trough | Juvederm Ultra XC | Under Eye / Lips | 1 cc | RM 2,400 | RM 2,200 | - | RM 2,200 | - | Benefit text mentions under eyes / tear troughs; source shows trial/promo note as ?? |
| Tear Trough | Belotero Balance | Tear trough area / Under Eye | 1 cc | - | RM 2,200 | - | RM 2,200 | - | - |
Treatment
Tear Trough
Product / Option
Juvederm Ultra XC
Parts / Areas
Under Eye / Lips
Units / Session / Duration
1 cc
Normal Price RM
RM 2,400
Selling Price RM
RM 2,200
First Trial Price RM
-
Promo Price
RM 2,200
Standard Package
-
Trial / Promo Notes
Benefit text mentions under eyes / tear troughs; source shows trial/promo note as ??
Treatment
Tear Trough
A published stepwise assessment framework from the journalAesthetic Surgery Journal (2024) found that precise patient categorisation before treatment was the single most important predictor of tear trough filler satisfaction.
[Aesthetic Surgery Journal, PMC Stepwise Assessment Framework for Tear Trough, 2024]
What to expect and what influences your results
Most patients schedule maintenance top-ups between 12 and 15 months to maintain optimal results.
Fast metabolism, first-time patients
Most patients with standard metabolism
Optimal product, good cheek support, ideal metabolism
Results vary by product brand, individual metabolism, and cheek support.
Patients wanting a complete under-eye and midface plan often explore cheek filler at Nexus Clinic as a companion treatment to tear trough filler.
What to expect after treatment
If filler is placed too superficially, it can create a bluish tint visible through the skin. This is prevented by deep placement with correct product and reversed with hyaluronidase if it occurs.
Patients who want to address pigmentation-related dark circles alongside their structural tear trough treatment can explore skin booster in Malaysia for skin quality improvement at Nexus Clinic KL, including treatments for dark eye circles.
It depends entirely on what is causing your dark circles. If your dark circles are caused by hollowness and shadow from a sunken tear trough, filler will significantly improve them. If they are caused by brown pigmentation from excess melanin, filler will not help. If they are caused by blue-purple vascular showing through thin skin, filler provides partial improvement at best. The doctor diagnoses your dark circle type at consultation before recommending treatment.
Tear trough filler typically lasts 9 to 15 months. The under-eye area has very little muscle movement, which means the filler breaks down more slowly than in high-movement areas like the lips. Some patients report maintained improvement for over 12 months with soft products like Belotero. Individual metabolism and the product used affect longevity.
Tear trough filler at Nexus Clinic KL typically ranges from RM 2,200 to RM 2,600 per session depending on the product used and the level of correction required. Combined tear trough and midface treatments, such as cheek support, generally range from RM 3,000 to RM 5,000+ depending on the volume and areas treated. All pricing is confirmed after consultation to ensure safe and personalised treatment planning.
When performed by a trained medical doctor with the correct product and technique in a proper clinical setting, tear trough filler has a strong safety record. The most common complications, the Tyndall effect and migration, are related to technique and product selection rather than the treatment itself. At Nexus Clinic KL, tear trough filler follows strict assessment criteria, product selection guidelines and cannula technique to minimise these risks.
Most patients need 0.3 to 0.8ml per side for natural-looking correction. This is one of the lowest-volume areas on the face and should stay that way. More than 1ml per side in a single tear trough session is rarely clinically appropriate and increases the risk of puffiness, Tyndall effect and migration.
Yes. HA tear trough filler is fully dissolvable with hyaluronidase. If you develop the Tyndall effect, puffiness, migration or are simply unhappy with the result, the filler can be partially or completely removed. This reversibility is particularly important in the under-eye area given the high visibility of complications. At Nexus Clinic KL, hyaluronidase is available at every filler appointment.
For many patients, cheek filler should come first. When the cheek has descended and is contributing to tear trough depth, filling the tear trough without addressing the midface support produces a less natural, less long-lasting result. The doctor assesses the relationship between your cheek position and tear trough depth at consultation and advises the optimal sequence.
The clearest sign that you are a suitable candidate is that your under-eye concern looks like a hollow groove or dark shadow rather than a puffy swelling. If you look tired but your under-eye is more sunken than puffy, filler is likely appropriate. If you have significant puffiness or eye bag fat protrusion, filler is not the right treatment. A proper clinical assessment at consultation confirms candidacy definitively.
The Tyndall effect is a bluish discolouration that occurs when filler is placed too superficially under the very thin under-eye skin. The HA gel scatters light through the skin surface and creates a visible blue tint. It is the most common complication of incorrectly performed tear trough filler. It is prevented by deep placement on the periosteum using a low-hygroscopic soft product via cannula technique. If it occurs, it is treated with hyaluronidase.
Looking tired despite adequate rest is one of the most common complaints that brings patients to aesthetic clinics. When the cause is structural hollowing, filler is the most effective solution available.
At Nexus Clinic KL, the assessment comes first. Every tear trough treatment starts with a diagnosis. You leave knowing exactly what is causing your under-eye concern and whether filler is the right treatment.
Limited slots available this week | Located at Wisma UOA II, Jalan Pinang, KLCC — Serving Malaysia since 2001