Eyelid Surgery Q&A

75%

WORTH IT RATING

477 Reviews

Ask a Question

View Before and Afters

Average Eyelid Surgery Cost: $3,875

Learn about Eyelid Surgery

2,260 people and 796 doctors are talking about Eyelid Surgery

Get Free Email Updates

Fillers or Blepharoplasty on my Tear Trough?

asked 1 year ago by 8422anon in Germany
Latest answer by Rian Maercks, MD
Question viewed 1,293 times
Tags: age 25-34, tear trough, female, puffy eyes

I am not sure whether fillers or blepharoplasty would solve my problem. I am 29 years-old, i have always had a little puffiness around the eyes (probably due to water retention and allergies) and now i have these terrible tear throughs under my eyes, which make the puffiness look worse. Thank you very much in advance!

23 answers to Fillers or Blepharoplasty on my Tear Trough?

Fillers for tear trough

This can be a difficult problem. At your age I would recommend against a blepharoplasty mostly because in 3-5 years you will be faced with the same problem again. Fillers on the other hand are easy and can be done as needed over the years. The problem with fillers is a matter of technique...it must be done by someone with experience and good results or it can show

Richard Galitz, MD
Miami Facial Plastic Surgeon

Fillers or blepharoplasty for tear troughs

The puffiness around the eyes is best treated with a lower transconjunctival blepharoplasty. We do no recommend fillers around the eyes because we have seen numerous problems with it including long-term puffiness over several years duration and does not go away unless specifically treated or have it removed.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Tear trough

As a first non permanent option I would try the fillers using Restylane. The small amount of fat displacement and herniation could be addressed surgically should it become more obvious with age. As with any surgery this comes with risk, be it small.

Lee Kleiman, MD
Annapolis Facial Plastic Surgeon

Fillers would be a good option for treating the eyes

From the pictures, it would appear that you have some puffiness due to movement of fat as well as some hollowing along the tear trough. It does not look like either is too significant but, due to their proximity, they can both look worse than they actually are. I don't think surgery would be the wrong approach but I would opt for a filler as you are young and the puffiness is not very severe. I think all of the fillers work very well in the tear trough. ... more

Jonathan Sonne, MD
Naples Facial Plastic Surgeon

Correction of tear trough

Both lower blepharoplasty and fillers such as fat or hyaluronic acid may be used to correct prominent tear troughs, which you seem to have. The procedures carry different risks and offer different results, and are not mutually exclusive. You should consult with a board certified plastic or oculoplastic surgeon to review all options before proceeding.

Olivia Hutchinson, MD
New York Plastic Surgeon

Eye bag treatment for tear-trough hollow: Eyelid #plasticsurgery or Injection

Hi 8422anon in Germany, As other plastic surgeons have stated, both are good options for appropriate candidates. Plastic surgery of the eyelids is generally reserved for older individuals, while injections are better options for younger patients. If you choose cosmetic surgery, then only conservative eye fat would be removed through an incision on the inside eyelid. Office injections of hyaluronic acid (Restylane or Juvederm) can help reduce the bags, but are not FDA... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

www.potomacplasticsurgery.com

Either would solve your problem

Dear Anon, Either procedure would/could correct your tear trough hollowing. Fillers are obviously less invasive and carry a lower risk. None of them are FDA approved for filling the tear trough however and if you accept that fact you could proceed with them. With your history of allergies expect some significant swelling and possibly even severe bruising even with fillers. At your age, it is difficult to recommend blepharoplasty, but only you can decide what... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Restylane or Blepharoplasty for Lower Eyelid Hollows?

Hello in Germany, Restylane used conservatively and properly placed in your lower eye lid hollows would be best for you. Choose your injecting physician most carefully. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Tear torugh treatment

Probably the best thing for you would be a little filler in the tear trough. You do have a bit of herniated fat as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Very subtle issue.

Filler with Restylane is probably your best option. You will need about 1 ml under each eye. This service will last about a year or more. Lower eyelid surgery should be limited to transconjunctival lower blepharoplasty with arcus marginalis release to place the lower eyelid fat at the top of the cheek. However in 5 to 10 years your under eye hollows will reoccur and again filler will be the option. Avoid overaggressive surgery if at all possible. more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Fillers First For Younger Women

In a patient who is farily young and has minimal skin laxity, it is advisable to try a filler first. While not permanent, it does a good job of softening the transition from the eyelid to the cheek, masking the tear-trough deformity. I prefer JuvadermXC, with the lidocaine built in. It should alst about 18 months. I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon

Bleph is best.

You get what you pay for, would say the bleph is best. If you are comparing fillers vs a Blepharoplasty for lower lid bags then the Blepharoplasty is much better, there is little risk, a consistent result is predictable and the result is more long lasting. If you don't have time and want something temporary then a filler can be used but the results are not as predictable as a Blepharoplasty

Walter D. Gracia, MD
Arlington Plastic Surgeon

Blepharoplasty vs Fillers

Either option is viable as outline by others. Blepharoplasty (transconjunctival approach) is a more permanent approach versus using fillers which are not permanent and usually last about 1 to 1 1/2 years in that area. You may simply try a filler first to see how things look and later on decide on having surgery. Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Fillers or Blepharoplasty on my Tear Trough

Great photos thanks!!! I would try a filler first like restylane or Selphyl. If than unhappy you can proceed to blepharoplasty by the transconjunctival approach.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Correction of the Tear Trough Indentation: Fillers or Surgery

The Tear Trough Indentation is the result of a shortage of soft tissue buffer between the lower rim of the eye socket and its overlying (very thin) skin. There have been numerous proposed solutions for this deformity which can be divided into 2 groups: Surgery and non-surgical. SURGERY - There is an eyelid surgery technique which uses an outwardly invisible, inner eyelid incision which transfers the bulging lower lid fat to cover the lower rim of the eye socket. This solves the "pooching"... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Fillers are an effective "blepharoplasty" in younger individuals

In young individuals such as yourself without significant aging or prominence of the fat in the lower lids, fillers placed deeply in the tear trough can work wonderfully to reduce the line and tired appearance. HA fillers are very safe as are small fat transfers which may be more lasting. Avoid longer lasting fillers as problems will be hard to reverse. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

Fillers versus blepharoplasty for treating the tear trough

You should definitely have fillers performed. I suggest trying a hyaluronic acid based filler such as Juvederm first. Stay far away from permanent and semipermanent fillers as there is a host of long term complications that you want to avoid. If you are pleased with the results I would suggest converting to fat grafting which can be permanent. Fillers will do a better job with the tear trough then a blepharoplasty in your face because your zygome is at what we call a... more

Rian Maercks, MD
Miami Plastic Surgeon

www.rianmaercksmd.com

Lower Lid Blepharoplasty or fillers for “Tear Trough.”

What I see in your pictures looks like “fat herniation.” If it is, then either procedure would be appropriate. Fillers are fast, easy and relatively inexpensive, but only temporary. Surgery is permanent when done properly, but more expensive and has some down time. If choosing surgery, do not allow anyone to simply remove the protuberant fat, as you will need it in the future.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Correcting tear trough deformity

If the puffiness does not change significantly day by day, it is probably orbital fat that has become more visible as the subcutaneous tissue shrinks in the tear trough. You would do well with filler injection such as Juvederm or a lower blepharoplasty with fat repositioning into the tear troughs.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

Filler or Lower Lid Blepharoplasty

You indicated that you have always had the puffiness under your eyes to some degree and have attributed it to fluid retention. As my colleague indicated you do need to know if this is entirely fluid retention, bulging fat or a combination of both. One question I ask my patients with this issue is if the puffiness is always present or is it worse in the mornings when you wake up and is not as noticeable as the day goes on. The puffiness caused by fluid retention cannot be... more

Arnold Zweig, MD
Atlanta Facial Plastic Surgeon

Volumizing to Correct Tear Trough Deformity

I would recommend you consider either injectable fillers, such as Restylane, or fat transfer to correct unwanted shadows along your tear troughs. Restylane is a beautiful option for in-office, minimal downtime correction of the hollowing under the eyes. Unfortunately, the results are temporary, lasting usually 9-12 months. An alternative that is more long-term is fat transfer. This involves more of a surgical procedure where fat is taken from one area of your body (for instance, the flank or... more

John M. Hilinski, MD
San Diego Facial Plastic Surgeon

Filler for tear trough

Well, the first thing I would find out if thisn is water retention or actual orbital fat. There is a subset of patients that have hereditary pseudoherniation of orbital fat. That just means that the fat is creeping out under the eyeball, something that happens with age. However, some patients can have it begin in their late twenties. If this is your case (fat), then I would have it removed surgically. This will give you a permamant treatment, which will be better and more economical over the... more

Andres Bustillo, MD
Miami Facial Plastic Surgeon

Fillers would be ideal for you

In my practice I would suggest one of the fillers for you for a few reasons -First, at 29 you are relatively young for a Blepharoplasty. Second, skillfully injected fillers would give you an excellent result lasting many months. Third, filler injection is much less invasive and consequently has less risk than surgery(even though the risk of lower eyelid Blepharoplasty is very low). Hope this helps