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Lower Blepharoplasty for Tear Trough Bags?

asked 3 years ago by berykute1 in Encino,Ca
Latest answer by William Bruno, MD
Question viewed 3,231 times
Tags: lower eyelids, tear trough, candidate, eye bags

I tried fillers for my tear trough bags, and it only made the problem worse! Can a lower blepharoplasty correct this and get rid of the bags?

16 answers to Lower Blepharoplasty for Tear Trough Bags?

Blepharoplasty for bags and tear trough

Lower eyelid lifts or blepharoplasty can improve the appearance of the bags under your eyes and the tear trough as well, depending on the technique used. With modern techniques, there are bascially three methods to treat the lower eyelid bulges: 1) Fat removal - Here the excess fat is removed. This will not affect the tear trough significantly, although it can in select cases. 2) Fat Hernia Repair - Here the fat is placed back where it came from and the lowereyelid tissues are closed... more

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon

www.drsteiger.com

Lower Eyelid Fat Pads or "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. As with skin... more

Michael Law, MD
Raleigh-Durham Plastic Surgeon

michaellawmd.com

That's exactly what lower blepharoplasty does

The lower lid blepharoplasty is designed to do exactly that: remove the bags, along with tightening up the skin. The trend now is to reposition the fat bulges that cause bags, rather than removing them, for more natural and durable result. It's a shame that the injections made it worse though, since when done right that can be very successful. Yours may have been placed too high or too superficially. It is important to consider timing too, it may make the most sense to wait until the filler... more

Richard Baxter, MD
Seattle Plastic Surgeon

Fillers can't address what surgery can for lower eyelids

Some patients have a hollowness under their lower eyelids which is commonly termed a tear trough deformity. This is caused my several different issues, it can be due to excess skin, protruding fat or loss of volume which occurs as we age. This needs to be correctly diagnosed before a treatment plan can be formulated. Lots of people think that an injectable such as Restylane or Juvederm can simply be injected into this area for correction. Sometimes that is helpful (in... more

William Bruno, MD
Beverly Hills Plastic Surgeon

Tear Trough Procedures Very Helpful for "Bags"

The lower eyelid area is challenging, but results can be very rewarding. I am sorry that fillers are not working out. I suspect you had a hyaluronic acid product (Restylane/Juvederm) and would suggest that you have that dissolved using hyaluronidase. That should at least return your lids to pre-treatment condition. You could try having a different doctor re-inject them at a later date if you think it was just poor placement the first time. I recommend using... more

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon

www.dr-apo.com

Tear troughs

The approach to the tear troughs is a complex question and is dictated by the patients individual anatomy and characteristics. Common techniques that are approached by themself or in conjunction include: Correction with filler (fat, HA) (See below weblink for just filler) Reposition of fat Removal of fat lower eyelid All of the above are extremely technique sensitive and both the choice and application of the technique are surgeon dependent. ... more

Anil R. Shah, MD
Chicago Facial Plastic Surgeon

Fillers like Restylane and Radiesse work well for tear trough problems

Fillers may be placed in the tear troughs when there is a depression in the tear trough. Because each individual's anatomy is a little different, it may take a few attempts and a very skilled injector to treat more challenging cases. Depending on the type of filler placed, you may have the filler dissolved (if it is a hyaluronic acid), you may have to wait for it to be absorbed (if it is Radiesse), or you may simply need more filler placed to complete the improvement. (This is the... more

David Mabrie, MD
Bay Area Facial Plastic Surgeon

"Tear trough" can be fixed by fat from a lower lid blepharoplasty.

If you indeed have a true tear trough abnormality, there exists a depression in the bone on the side of the nose adjacent to the eyelid. During a lower lid belpharoplasty, fat from the medial compartment can be position to fill the trough. This is a permanent fix with fat that is otherwise removed with the eyelid surgery. The fact that fillers didn't help makes me question your diagnosis of tear trough abnormality. Almost always this is a good, but temporary, fix.... more

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Dark circles and lower eyelid bags

The tear trough depression or "dark circles" are often due to more than one variable. Protruding eye socket fat (above) can make the depression more visible. Also, tissue laxity surrounding a structure called the orbitomalar ligament sometimes contributes to the concavity or sunken appearance. Fillers sometimes are enough, but some people benefit more from surgery including fat repositioning and/or release of the orbitomalar ligament.

Jeremiah P. Tao, MD
Irvine Oculoplastic Surgeon

Lower blepharoplasty for tear troughs

For isolated tear troughs (areas of concavity between the inner portion of the lower eyelid and the cheek), injectable fillers such as Restylane are usually successful. For tear troughs associated with lower eyelid bags (bulging fat) and/or skin laxity, lower eyelid surgery is quite reasonable. Techniques vary from surgeon to surgeon, but all entail filling the tear trough with fat. I usually elevate the lower lid muscles from the bone at the level of the tear trough and then... more

Ronald Friedman, MD
Dallas Plastic Surgeon

Lower blepharoplasty can correct tear trough.

Hi! A well performed lower blepharoplasty with fat REDRAPING ( not fat removal) can correct the tear trough deformities. But I have to tell you that this is difficult surgery. Ask to see a lot of before and after pictures.

George J. Beraka, MD
Manhattan Plastic Surgeon

Tear trough correction requires transconjunctival blepharoplasty with fat grafting or repositioning

The depression beneath the lower eyelid at the beginning of the tear trough near the nose and extending out beneath the lower eyelid can be corrected by a VERY SPECIFIC type of lower blepharoplasty. Most patients call this condition dark circles under the eyes. The tear trough is more commonly associated with the depression as it moves out toward the cheek. Traditional lower blepharoplasty with fat removal may make the deporession near the lower eyelid worse. The modern approach to this... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Lower blepharoplasty can help

The teardrop bags can either be removed through a transconjunctival approach with a lower blepharoplasty, or they can be re-contoured and then the fat used to fill the teardrops. It really depends on the individual anatomy and aesthetic goals that the patient wishes to have performed during the lower blepharoplasty procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Lower eyelids

Treatment of the lower eye lids can be as simple as just removing some s kin, to removing some fat or even repositioning of fat to camouflage the lower margin of the orbital rim. Fillers can camouflage some of the problems as well. It sounds like you may need surgical treatment to correct your problems.

Steven Wallach, MD
Manhattan Plastic Surgeon

Treatment for lower lid problems

The lower eyelids can look old because of several anatomic issues. 1-sagging, excess skin - treatment is blepharoplasty. 2-Sagging, lower eyelid muscles and tendon - tightening of the muscles is called a canthopexy or canthoplasty. 3- Bulging fat creating a bag - treatment is a blepharoplasty. 4-Tear trough deformity - a depression below the bag caused by a loss of cheek fat in the area, or a split in the muscles between the eyelid and the nose - treatment is fat augmentation and a few... more

Robert M. Freund, MD
New York Plastic Surgeon

Lower blepharoplasty is designed to eliminate fat bags

Lower lid surgery is primarily designed to remove or redistribute bulging lower eye fat pockets. It is much less for skin removal than for protruding fat elimination. In the past, the fat removal was aggressive and the skin removal was also. This led to many problems with hollow eyes where the outer corner rounded out or pulled down. Currently, the procedure is done differently. The protruding fat is either very conservatively removed or it is redraped into the tear trough to fill it in... more