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filler or blepharoplasty for my tear trough?

asked 6 months ago by azguy in Arizona
Latest answer by Donald M. Brown, MD
Question viewed 257 times
Tags: tear trough, filler, pre-op

My deep tear troughs are starting to really make me self-conscience.  I have been reading the pros and cons of each and am not sure what would be better.  I have barely gotten enough courage to consider a filler but I hear that they are difficult in this area to work properly.  I don't know if I could see myself having a blepharoplasty since its surgery (and I'm worried about not looking like myself once its done).  The fillers seem to be easy but everybody says to find an "experienced" person.  I talked to one board certified plastic surgeon who performs fillers but won't do them in the tear trough area because the results are so inconsistant.  Also, it appears that there are several different kinds of fillers as well.  Based on my photo, what would be recommended? 

18 answers to filler or blepharoplasty for my tear trough?

+2

Tear Trough Filler

I think you could get a great result with fillers put into the tear trough region in the right hands. This would be a conservative way to start. If you are then looking for something more permanent, you could explore having a lower blepharoplasty / fat repositioning at that point.
Kimberly Lee, MD

Beverly Hills Facial Plastic Surgeon

www.beverlyhillsfacialplastic.com

+2

Restylane and other fillers for tear trough area

It is interesting to read the answers from multiple physicians. It just goes to show that there is no single approach to your issue and the issue of tear trough in general. If you go to different doctors, their answer will depend on their aesthetic evaluation of your situation (some think you don't have a problem, some think it is a huge deal), on their experience with the possible solution (have they done a lot of fillers? Or many surgical blepharoplasties?),... more
Stella Desyatnikova, MD

Seattle Facial Plastic Surgeon
+2

Restylane injections to tear troughs work very well.

Hi. From your picture, I would say that you are a much better candidate for fillers than for surgery. The issue is that these injections have to be done just right. You inject tiny amounts of Restylane, deeply, right against the bone and under the muscle. The results can be excellent and last three years.
George J. Beraka, MD

Manhattan Plastic Surgeon
+2

Oculoplastic surgeons are more likely to offer this type of service.

You are doing the right thing to search for an injector who offers this service. Experience really does matter here. If the surgeon say that they do not do the service, please do not make them do the service.
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+2

Filler for tear trough area

I would recommend that you see another board certified plastic surgeon or dermatologist who is an experienced injector. I think you would benefit from Restylane in the tear troughs and have not personally found the results of such injections to be inconsistent.
Robert L. Kraft, MD

New York Plastic Surgeon
+1

Treatment options for the tear trough

Thank you for your question and photograph. It does not appear from your photograph that you have an excessive amount of fat above the tear trough so your best option would be to correct the tear trough depression using a filler such as Restylane.
Donald M. Brown, MD

San Francisco Plastic Surgeon
+1

Tear Trough Procedure

Excellent feedback from panel members. As many have stated, you will likely see much benefit with Restylane to this area. I recommend consulting with several injectors in this area and selecting the provider you are most comfortable with. A practiced injector can show you photos of their work and honestly evaluate your needs.
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon
+1

Restylane for the Tear Trough

Thank you for the photos. You would be a good candidate for filler injection into the area. I would not recommend surgery for you as it would not address the problem. You have hollowing in the tear trough area, which a HA filler like restlylane would work very well. Most board certified plastic surgeons would and do perform this procedure on a regular basis, so I would look around for such. It is not a very difficult area to inject but you do need to find someone... more
Farbod Esmailian, MD

Orange County Plastic Surgeon
+1

Restlyane works very well in the tear trough

I certainly agree with the previous reviews. After reviewing your photo, I am guessing surgery would be premature at this point. I would recommend a hyaluronic acid filler for this area. I use all varieties of these products but find that restlyane is the most reliable and affords great surgeon control in the tear trough. This is a very safe product I have been using for many years in the tear trough (although this is an off-label application). If by chance, you... more
Todd Christopher Hobgood, MD

Phoenix Facial Plastic Surgeon
+1

Fillers for the tear trough

Based on your photo, I would start with Fillers. However, even in experienced hands, the outcomes can be variable. Sometimes, people need more than the physician puts in and needs a touch up. I recently had a woman who I treated six months ago and she was thrilled with her results. I recently did the same treatment with Restylane in the same place with the same amount and she wasnt happy. It turned out that she just needed some more product. I put a little more in and she was thrilled... more
Kenneth Beer, MD

Palm Beach Dermatologic Surgeon

www.palmbeachcosmetic.com

+1

Fillers vs blepharoplasty for tear trough

I believe you are a good candidate for filler in the tear trough. The results are very consistent and reversible.. The best filler for this area are restylane or juvederm. These are both hyluronic acid fillers, are malleable and easily reversible with hyulronidase. A blepharoplasty would be inappropriate for your condition and has the potential to change the look of your eyes. My experience is that the hyulronic acid fillers can last up to three years in... more
Robert M. Jensen, MD

Medford Plastic Surgeon
+1

Treatment recommendations for the tear trough

Your treatment could be done easily and fairly inexpensively with one 0.5 cc syringe of Restylane. Clearly you have to find a physician who is both comfortable and skilled in injecting this area. I personally have not found the results of treating this area to be inconsistent. Look for a board certified cosmetic dermatologist or plastic surgeon. Always ask about the experience of the injecting physician and make sure they have all of the "tools" to use, such as all of the various... more
Mitchell Schwartz, MD

South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

+1

Filler or blepharoplasty for my tear trough?

IMHO, your tear troughs are not that deep nor are there significant fat bags in the lower eyelids. IMO, you should consider shaping the cheeks to make the face appear more angular and ruggedly handsome. Perlane is a great filler for cheek augmentation. This will make the face more attractive and divert attention away from the tear troughs.
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Restylane 0.5cc or less to your tear troughs will do it

You would do well with Restylane in your tear troughs. You don't need blepharoplasty. You do need to find someone experienced in this technique. It sounds like you are asking the right questions because you found out that the plastic surgeon you consulted is not experienced in the technique! Just consult with a few more physicans (plastic surgeons or dermatologists) who perform a lot of fillers. You will find someone. Don't take any aspirin,... more
Anne Marie McNeill, MD

Newport Beach Dermatologist
+1

Fillers for tear trough

Fillers are great for the tear trough but have to be placed very delicately. A blepharoplasty can remove fat and skin.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Get a good exam and talk to several experts.

First, I would need more views and different lighting to tell more on this web site. Not all cases can be resolved with fillers. Some patients need a bleph and filler. Some only one or the other. However, fillers can often provide significant improvement in the tear trough. Blepharoplasty reduces the fat........above.........the tear trough. Protruding lower eyelid fat can exaggerate the tear trough by making it more visible; so, by reducing the protrusion above the tear trough you might... more
Phillip Langsdon, MD

Germantown Facial Plastic Surgeon
+1

Filler vs Blepharoplasty for the Tear Trough Area

I think you should have a consultation with an occuloplastic surgeon first. Most of the time they may be able to re-position the fat back down in the tear trough area. This would be a more permanent solution to your problem. If you are not comfortable with plastic surgery, a filler such as Restylane would be the best option. For this I would recommend that you seek out the injector in your area that has the most experience injecting the tear trough. It is... more
Sheri G. Feldman, MD

Beverly Hills Dermatologist
+1

I think you would do well with fillers

Good quality photo. It shows your issue very well. I think that one of the hyaluronic acid fillers (Juvederm or Restylane) would work well. Do go to someone who is comfortable with the technique. Good luck, Dr T
Scott Tucker, MD

Winston Salem Plastic Surgeon

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