Eyelid Surgery: Q&A
Ask a QuestionBlepharoplasty or Filler in the Tear Trough?
I HATE my under eye bags. They are genetic. I want to have them fixed. My aunt had it done but 10 yrs. later she has hollow, sunken orbital area. I don't want that so I am considering having a filler put in my tear troughs, but I've heard horror stories. I've tried every type of cream, home remedy, etc.
I'm 39 and I don't want to look like I'm in my 40's. I'm attaching a pic taken with light over my head so you can see the bags well. Suggestions?
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34 Doctor Answers |
Asked by
cravingbeauty
in Milwaukee, WI
+4
Arcus Release and Fat Grafting Best for Tear Trough Avoid Filler Injection
Thank you for your email. I do see the depression beneath your lower eyelid called the Tear Trough and the puffiness of the lower eyelid above the depression. Some call this Dark Circles under the Eyes.
This is best treated with the Transconjunctival Blepharoplasty with Arcus Release and Fat Grafting. See the link below for a detailed explanation of the correction of Dark Circles under the Eyes.
Filler injections into the lower eyelid are dangerous in inexperienced hanbds and can...
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+3
Blepharoplasty better for you overall with the right surgeon
I think surgery is the better choice for you and here's why:
You have an abundance of fat that can be used to reposition over the hollow areas under your eyes and in your tear troughs. This method avoids the over-hollowing some patients experience. The fillers are fine but do not last very long and have a high risk of bruising (so does surgery but at least it's a one time thing). Just make sure you see a surgeon who is not overly aggressive about fat removal and more conservative in the...
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+3
Lower lid blepharoplasty or dermal fillers
There are many valid arguments for each type of approach to rejuvenating the eyes in lower lid Blepharoplasty. You are young and it is clear that the herniated fat that your lower eyelids exhibit is genetic in origin. You are definitely a candidate for filler in this area but, you are also a fantastic candidate for a conservative transconjunctival Blepharoplasty of the lower lids. If you have dermal filler placed in the lower lids, you will need to have the procedure repeated every 7-9...
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+2
Eyelid surgery with fat transfer would give the best result
Fillers can help disguise the bags but have a risk of irregularities. You note that your aunt has a hollowed out look, and this is the reason that I would recommend not removing fat from your lower eyelids, but rather transferring fat to fill out the tear trough grooves (the grooves between the lower eyelids and the cheeks). This has the combined benefit of getting rid of the puffiness, putting the fat to good use to fill out the grooves between your lower eyelids and cheeks, and preserving...
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+2
You would benefit from a combined approach
You have excess fullness in the inner half of both lower lids. You also have hollowness under the eyes in the tear tough area. In my practice we would advise that you not have a blepharoplasty alone but rather a lower lid fat repositioning (sometimes called a fat pedicle transfer). In this procedure the lower lid fat pedicle is rotated and transferred to the tear tough area. This combined approach reduces fullness in the lower lids–where you do not like it–and adds fullness to...
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+1
Dark circles under eyes. Fillers or surgery, what is best. Answer from New Jersey
You are asking a very important question that deserve a careful answer. Fillers are a good way to improve the lower lid appearance by filling the dark circles that start by the nose, the so called tear trough area. This can be done safely and effectively by a technique that I describe in a blog on my web site today in response to your question and other questions that I have received recently. In your situation you present with an eyelid bag which is the orbital fat protruding...
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+1
Blepharoplasty or Filler in the Tear Trough
I think everyone is in agreement that a combination approach is best. That is, a transconjunctival approach to the lower lid and transposition of fat. Then either fat grafting or Restylane or Juvederm would help with the overall picture.
+1
Under eye treatment options
Fat transfer, fat grafting, fat injections, and structural fat grafting are basically the same. This involves taking live fat cells, protecting and processing them, and re-injecting or placing them in an area where more fat or bulk is needed. Some special terms are used for marketing purposes, but it is all fat grating. There is a greater possibility of irregularity of result with fat than with fillers. That is because it is difficult to place very tiny strands of fat under...
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+1
Under eye bags
A very common aging change in the lower eyelids is the development of 'bags', which are in most cases due to an outward bulging of the fat pads behind the lower lids. These 'bags' of fat can be improved by conservative removal through an invisible incision on the inside of the lower lid (trans-conjunctival approach) in patients that do not require skin excision, or through the under-eyelash (sub-ciliary approach) in patients that are having some excess lower lid skin removed...
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+1
Sunken eyes after blepharoplasty result from old-fashioned surgery
The result that you don't like in your aunt is only because she had fat removed--which is what we did all the time 20 years ago. Now we pay much more attention to fat preservation and transposition--moving the fat so that it fills the tear troughs--and the sunken eye problem is much less common.
Fillers will buy time. They are less expensive but temporary. Your decision just depends on what you can handle in terms of time and expense. Ultimately...
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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