Tear troughs are created by the hollowing of the under eye area that can result from the gradual loss of connective tissue and subcutaneous (under-skin) fatty tissue from the eye area. The result is a loss of facial volume and tissue elasticity — in the cheek area as well as under the eye — along with a mild reduction in bone volume and a general descent of skin.  These not only combine to create tear troughs. They also accentuate dark circles under the eyes, making people look tired and worried, even when they’re well-rested and happy.

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