Hollow under eyes can sometimes be an illusion, a result not just from the tear troughs themselves but from a volume deficiency in the upper cheek volume. Age-related volume loss in the cheeks can emphasize under eye hollows. In such scenarios, merely filling the tear trough may not provide the desired outcome. Without the supporting "shelf" of the upper cheek, under eye fillers might make the eyes appear puffy and unnatural. Addressing the upper cheek with cheek filler is integral to achieving a balanced and youthful appearance.