Objective To explore the effect of injection filling combined with superficial dissection technique on symptom improvement in patients with tear trough-type dark circles. Methods A total of 106 patients with tear trough-type (structural) dark circles who received treatment in our hospital from January 2025 to January 2026 were selected, and they were divided into the control group and the observation group by the random number table method, with 53 patients in each group. The control group received simple injection filling treatment, and the observation group received combined treatment of injection filling and superficial dissection technique. The symptom improvement, satisfaction, adverse reaction rate and quality of life were compared between the two groups. Results After treatment, the scores of tear trough depression depth and dark circle pigmentation in the observation group were lower than those in the control group (P <0.05). The satisfaction scores of overall appearance improvement, tear trough filling effect, dark circle fading degree, skin smoothness and treatment comfort in the observation group were higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group (9.43%) was lower than that in the control group (26.42%) (P <0.05). All quality of life scores in the observation group after treatment were better than those in the control group (P <0.05). Conclusion For the repair of tear trough-type dark circles, injection filling combined with superficial dissection technique can effectively improve clinical symptoms, enhance treatment satisfaction and quality of life, with a low risk of adverse reactions and high treatment safety.