Permanent filler for tear troughs?

Is it effective to use a permanent filler like Radiesse or Artefill for my tear troughs / under-eye hollows?  What are the risks?

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6 answers to “Permanent filler for tear troughs?”

A: Tear Trough Correction with Fat Grafts

Michael Law, MD

In patients who have developed deep 'tear troughs' at the junction of the lower lid and cheek, adjacent to the side of the nose, the meticulous grafting of fat harvested from the patient's abdomen, hips or thighs can build this area back up and nicely restore a more youthful contour. In some blepharoplasty... more

A: Permanent fillers around the eyes are NOT safe

Stella Desyatnikova, MD

This website is a great resource enabling prospective patients to get unbiased information about all the possibilities, as well as the risks and dangers, of the today's world of aesthetic surgery. I would really like to caution prospective patients about the use of permanent fillers. In fact, I would go... more

A: LiveFill or fat injection are the best permanent fillers for tear troughs

Brent Moelleken, MD

Rejuvenation of the under eye area is different for different ages and degrees of problem.  As surgeons, we must be concerned not only giving a nice durable result to the patient, but also to preventing problems which can be long-lasting and in some cases untreatable.  The lower eyelids are... more

A: Fat grafting is the best permanent filler for facial contouring, but I use Juvederm more

Stephen A. Goldstein, MD

Treatment of facial contour irregularities are both technically and aesthetically demanding.especaily in the tear trough area.  Artefil is a permanent filler that is approved FDA; however, I would not advise injection this particular soft tissue filler because it is permanent... more

A: The only good permanent filler is your own tissue

Robert M. Freund, MD

The tear trough or nasojugal groove is the depression under the eye that can be present genetically from an early age or more often occurs as we age. The depression is the result of several different things happening at once. The fat that bathes the eyeball starts to puff out. The bottom edge of the puffiness... more

A: Get a very experienced injector for permanent fillers

William Groff, DO

First, Artefil is the only permanent filler FDA approved in the USA. That being said, none of the fillers are FDA approved in this area. The tear trough area can be one of the trickiest and unforgiving areas to use fillers. With that in mind, I do not recommend Artefil for this area. Radiesse is a good... more

Comments

Dr. Steve Williams
587 posts
24 Nov 2008

I wholeheartedly agree with the other doctors - the lower lid skin and skin below the lids commonly known as the "tear trough" is extremely thin and delicate. Complicating matters, typically patients seeking improvement of this area have even thinner skin. This can predispose them to significant contour abnormalities which can persist after the filler should have dissolved. Typically good correction can come from a lower lid blepharoplasty which resects some of this skin and resuspends the fat pads to create a more youthful look. Hope this helps. Best. Dr. Steven Williams Tri Valley Plastic Surgery

Susie Hurley
unregistered guest

8 Feb 2009

I had the hollows under my eyes filled with fat transferred from my abdomen. The results were great and long lasting...4yrs. My surgeon explained to me how fat vascularizes and gives longer and more natural results. I would do this again if ever needed.

Kenneth Oleszek, MD
1 post
19 Nov 2008

In my experience Juvederm or Restylane is best for the tear troughs.  Although these fillers are temporary, I find they are quite long lasting (over 1 year) and the treatment is relatively  fast, easy and with little complications.  This is one if my most popular treatments - giving the patient the 'WOW' change in just a matter of minutes. The concern I have with permanent fillers is that lumpiness can sometimes occur, because the skin in the tear trough area is very thin.  With Restylane or Juvederm, which are hyaluronic acid-based fillers, touch-ups are relatively easy.  But with other permanent fillers, correcting the lumpiness maybe more difficult. If a patient does want permanent correction, I will often refer to a plastic surgeon for blepharoplasty and/or fat transfer evaluation

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