Eyelid Surgery: Q&A
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Should I Have Blepharoplasty or Restylane on Tear Trough?
I am trying to decide if lower blepharoplasty (fat repositioning) or tear trough rejuvenation with Restylane is best for my problem? I have fat prolapse on my right side resulting in a more puffy appearance above the tear trough and on the left have more extensive hollowing.
I am just lost as to which gives best results. I am getting married in August & concerned with complications / recovery of the surgery but wonder if ultimately it is the better option? I have also been told that my mid face area seems to be attributing to the overall problem?
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19 Doctor Answers |
Asked by
eyebaghell
in UK
+3
I'd recommend the fillers
As said before, you are showing your eyelids in their most unflattering pose. Even here, though, I don't think you have enough fat to reposition and effectively hide your tear troughs. In my opinion you would still need fiiler so why not just do it all with the fillers in the first place. It eliminates the risks of eyelid surgery which are higher in the lower lids and sometimes are hard to correct. Even though they need repeating, the results are actually better looking that what surgery...
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+3
Transconjunctival Blepharolasty with arcus release and fat grafting
I do not recommend filler injections into the tear trough. While many doctors do them I have seen many complications such as visible lumps and discolorations. Blindness following filler injection around the eye has been reported in England.
The transconjunctival blepharoplasty with arcus release and fat grafting or repositioning is the most effective treatment for dark circles and tear trough deformity.
The puffiness of the lower lids will be corrected as well.
See before and after pictures.
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+2
A combination procedure works great for tear troughs
Removal of the excess fat is important to a great long term result, but be careful not to over resect it. I like to combine the fat reduction with a fat transfer into the tear trough or line under the eye. The fat transfer can give a very long lasting result and is quite predictable. A fat repositioning procedure has a little higher chance of resulting in lumpiness or incomplete correction. If the correction is incomplete with the fat transfer, you can simply put more in. Juvederm and...
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+2
Restylane vs. surgery
The photograph is not completely telling because you are looking up and a bit to the side, which accentuates the bags under the eyes. Your eye configuration is one of a prominent eyeball (globe); hand in hand with a large eye is often a very visible fat bulge below the eyes.
The most effective way to treat a bulge below the eye is with a transconjunctival blepharoplasty. That way the danger to the lower eyelid is very low.
If you try to build up the areas surrounding the bulges with...
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+2
Save yourself and don't have lower eyelid surgery.
Dear Eyebaghell
First it is not possible to position your face in a more unflattering manner. Looking up brings out the lower eyelid fat. So this will be your lower eyelid bulges at their absolute worst.
Second, there is no substitue for a personal consultation. Having said that, the biggest problem you have is a relative weakness in the projection of the orbital rim at the top of the cheek. This makes this area lack aesthetic strength and accentuates the tear though area. The arcus...
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+1
Eyelid surgery v Restylane
I agree that the photo isn't the most flattering but you should see how the Dept of Motor Vehicles captured me on my license picture! Either procedure would improve your appearance but I generally recommend that patients try a Restylane treatment initially. It's inexpensive, has basically no downtime and may give you an improvement. If you want to enhance the appearance of your eyes even more, then surgery is definitely an option. Congratulations on your forthcoming marriage!
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+1
Tear troughs and blepharoplasty
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.
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+1
Blepharoplasty a better solution
A blepharoplasty is a permanent solution to the tear troughs and fat bags underneath the lower eyelids. It appears in the picture that you do have herniated fat in the lower lids and tear troughs. Your midface area is also somewhat shallow and could be improved with cheek implants. We do not advise Restylane in the tear troughs because of complications that are associated with it, and it is only temporary.
+1
Angle of picture makes it difficult to tell
Hard to answer this question based only on the picture you provided, but both techniques can give excellent results in well-chosen patients. A physical examination by a surgeon would be most helpful to determining which is right for you.
+1
I believe restylane done correctly would give a quick result with little downtime
In my opinion the best result will be achieved with transconjuctival fat removal of the lower lid fat pads in combination with fat transfer to the tear trough in the same session.
Restylane injection could give great results but the physician must be experienced
Juvederm is a great product but I do not use it for lower lids as it looks too full
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