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?

Should I have Blepharoplasty or Restylane on tear trough?

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17 answers to “Should I have Blepharoplasty or...”

A: Blepharoplasty a better solution

By William Portuese, MD - Seattle Facial Plastic Surgeon

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... more

A: angle of picture makes it difficult to tell

By W. Tracy Hankins, MD - Las Vegas Plastic Surgeon

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.

A: I believe restylane done correctly would give a quick result with little downtime

By Amir Moradi, MD - San Diego Facial Plastic Surgeon

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... more

A: A combination procedure works great for tear troughs

By Shain A. Cuber, MD - New Jersey Plastic Surgeon

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... more

A: Restylane can correct the tear trough and more

By Peter E. Johnson, MD - Chicago Plastic Surgeon

Restylane and other HA fillers such as Juvederm are effective in correcting the tear trough and rejuvenating the lower lid without surgery. The application must be done very deeply with skill to obtain a good contour, an injection that your doctor should do rather than a nurse of technician. If the filler is... more

A: Try an injection of Restylane or Perlane first

By Michael Weinberg, MD - Mississauga Plastic Surgeon

I would try an injection of Restylane or Perlane first. Juvederm is also a good option. The results are very predictable and the downtime is minimal.

A: Restylane vs. surgery

By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

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... more

A: And then there is the 3rd Option...

By Frank P. Fechner, MD - Worcester Facial Plastic Surgeon

A careful filler injection of Restylane can be very effective with a surprising longevity of greater than 1 year. Personally, I do not like Juvederm for the tear troughs... Lower blepharoplasty with fat repositioning will give you a nice enhancement, too. Recovery is about 12 days. At the end, you may still... more

A: Try Restylane first.

By George J. Beraka, MD - Manhattan Plastic Surgeon

HI! It"s a difficult decision. The results of surgery are long lasting, but you have tricky anatomy (prominent eyes, flat cheek bones), so surgery on your lower eyelids will not be easy, and you will probably also benefit by having a mid face lift (through the mouth). So try... more

A: I'd recommend the fillers

By Richard P. Rand, MD - Seattle Plastic Surgeon

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... more

More answers to Should I have Blepharoplasty or Restylane on tear trough?
Boston - Transconjunctival Blepharolasty with arcus release and fat grafting
Fort Wayne - Both are effective.
Los Angeles - Save yourself and don't have lower eyelid surgery.
New York City - No eye baggage for the honeymoon
Southlake - Understand the end goals!

Comments

eyebaghell
15 posts
29 Apr 2009

Thanks so much for all the advice. So very helpful. I have done my research and found an Oculoplastic Surgeon so am going to have the restylane fillers as a temporary measure - fingers crossed it makes a difference...

eyebaghell
15 posts
5 Jul 2009

Just to update you on my experience. I did opt for restylane - however unfortunately it didnt work out for me. I didnt like the look asthetically and felt it looked artificial and changed the overall appearance of my face. I also had bruised like appearance under one eye due to the fact that blood from the bruising I had from the injections stained the restylane. After 4 weeks I had the restylane dissolved with hyaluronidase. Thankfully this was very straight forward, painless and worked within 24 hours. I am now back to where I started. I am however relieved that I opted for restylane and not surgery due to the fact it is reversible. The thought of having no choice but to live with a facial change after that I wasnt happy with after surgery doesnt bear thinking about. This website has helped me to express my concerns and ask questions but I do think it is important for people reading this to remember that every case is individual and that the most important thing is to seek out a qualified and reputable surgeon/dermatologist that you can trust. I also think that fillers like restylane seem like a 'safe' option which is why people are who wouldnt normally consider cosmetic treatments are taking the plunge. But as you will see on this website this isnt always the case - so dont jump into having injections without thinking long and hard about what you might be getting yourself into!

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