Tranconjunctival blepharoplasty can be an excellent approach for tear trough deformity

Scott Trimas, 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.


Scott Trimas, MD
6 months ago
By Scott Trimas, MD - Jacksonville Facial Plastic Surgeon

Correcting the tear trough deformity can be performed via the transconjunctival lower blepharoplasty. After conservatively removing excess fat in the central and lateral areas of the lower eyelid region, the fat stalk from the medial component can be stretched out to fill the tear trough and offers excellent long term correction of that area. In patients that I have performed this procedure on over the last three years, I have seen no recurrenc of the tear trough deformity and believe that the vascularized fat serves to maintain the correction over a long period of time.

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