6 months ago
You actually can have both. You can have a transconjunctival fat removal or redraping, release of the arcus marginalis and if needed at a later time, some filler along the arcus to camouflage better.
Tear troughs
Steven Wallach, 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.
More answers to “Best approach for tear troughs?”
A: No easy answer, but fat injections probably best.
7 months ago
To david_k,
Hi! It's fascinating to me how sophisticated patients have become so quickly. Two years ago, nobody knew what a tear trough is.
The two solutions you propose are effective. An even better solution is fat injections to create a smooth plane. The goal is not to be able to tell where the lower eyelid ends and the upper cheek begins; it's all one surface.
The problem is that all 3 techniques are quite difficult (and Restylane is temporary). So the best answer for you is: What is your doctor best at? Ask to see a lot of before and after pictures. And if you don't like what you see, go elsewhere.
Your problem is one of the most difficult in cosmetic surgery.
Contact the doctorBack to “Best approach for tear troughs?”
Eyelid Surgery: 195 reviews
64% said it was worth it
Eyelid Surgery before & after photos
IMPORTANT: As noted in our Terms of Service, the information found on RealSelf.com, including that provided by professionals in the Questions & Answers area, is a general educational aid. The Questions and Answers contain opinions and views created by community members. RealSelf.com is not responsible for the accuracy of any information posted by community members. Do not rely on this information as a substitute for personal medical or healthcare advice, or for diagnosis or treatment purposes.