Restylane can work for tear troughs

Philip Young, MD answers: Best approach for tear troughs?

I am 30 year-old male with tear trough at lower eyelids, like dark circles. Last year, I developed some small bags that make the dark circles worse. I have no excess skin. I visited some plastic surgeons, and I was offered Restylane injections or arcus marginalis release with fat reposition (not transconjunctival, since bulging fat is very close to tear duct and hard to deal with through that approach). Is this correct? How close to the bone and inner corner of eyelid can Restylane injections go? My grooves start from the very inner corner next to tear duct.


Philip Young, MD
6 months ago
By Philip Young, MD - Seattle Facial Plastic Surgeon

Both of those options can help. I think Restylane would be a better alternative to replace the volume that you have lost in the lower eyelid and cheek area. That is essentially what has happened -- a loss of volume. The only thing is that restylane will last only 6-9 months. Fat repositioning can help the condition but there are limitations. It can leave you looking hollow and it can impact the position of your eyelids and can have complications.

I don't prefer the fat repositioning procedure. I think volumizing the area is the best way to rejuvenate the face and the lower eyelid area. It can give you the most naturally looking results.  Fat transfer to this area is the best if done right.

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More answers to “Best approach for tear troughs?”

A: best solution requires examination

Richard Baxter, MD
7 months ago
By Richard Baxter, MD - Seattle Plastic Surgeon

There are a number of options available, as you can tell from the previous answers. The bottom line is that no one can tell what your best option is without seeing you personally, although the picture is helpful. My guess is that your best choice for the long term would be the fat repositioning option, though you may be able to "buy some time" with fillers such as Juvederm (Ultra Plus) or restylane/Perlane.

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A: Implants or fat repositioning

William Portuese, MD
5 months ago
By William Portuese, MD - Seattle Facial Plastic Surgeon

It is not a good idea to put Restylane around the tear troughs since there are complications associated with it, and it is only temporary. Your best options are tear trough-style cheek implants or fat repositioning through a lower eyelid blepharoplasty.

Web reference: http://www.seattlefacial.com
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