Solutions for tear trough deformity
It is important to distinguish between tear trough deformity which runs down the cheek from the corner of the from a deep nasal jugal fold which is a deep trough or depression directly under the eyelid which curves outward and upward along the eyelid. Filler injections aren't early method to try however when used on the eyelid skin and visible lumps can result. Fat grafting for the deep nasal jugal fold can be a permanent solution. Please see a board certified plastic surgeon for an examination and diagnosis.
Fillers vs. Surgery for Tear Troughs and Eye Bags
Thank you for the great questions. Your description of the issues is spot on. Unfortunately, as we age, the cheek fat descends and the lower eyelid fat starts to push forward. Since the lower eyelid skin is so this, this causes a contour abnormality and shadowing. And the result is dark circles and a hollow appearance. This can be treated very well using soft tissue fillers; I prefer Restylane for this area. The benefit of this option is that it is quick and does not require anesthesia or down-time. The downside is that it is temporary. For most patients, the filler material lasts about 9 months. A lower eyelid lift surgery is also a great option, and obviously permanent. In my practice, I use the lower eyelid fat to help fill in the hollow area of the tear trough. This requires about a week of downtime, depending on the patient. Best of luck moving forward!