Best approach for tear troughs?

Hi David, I would fill your hollow conservatively with Restylane initially, have you return to the clinic in about 10-14 days for a possible touch up.  The entire lower and lateral periorbital area needs to be in balance, usually there may be some feathering injections around the main defect to blend... more

Fortunately, modern cosmetic surgery offers options for correcting various facial problems. For your tear troughs, I would consider injectable fillers (I like Restylane for the tear troughs) or fat transfer (about 10cc of fat is usually harvested from the abdomen or hip region). Fat transposition in... more

Dear David: Yes there are all sorts of important structures in this area.  That is why your doctor really needs to know their anatomy.  The absolute deepest part of the dark circle is actually just at or a little below the bony orbital rim.  At the bony rim, there are essentially no important... more

There are a number of options available, as you can tell from the previous answers. The bottom line is that no one can tell what your best option is without seeing you personally, although the picture is helpful. My guess is that your best choice for the long term would be the fat repositioning option, though... more

The best thing to do is discuss this with some one that has had experience with all of the techniques.  Here is an analogy.  If you consult with a person and the only tool they have is a hammer,  they will treat everything like a nail.  If you discuss your options with a plastic... more

Our preferred option for your situation might be to do a transconjunctival blepahroplasty with fat repositioning and slight fat reduction, followed by fillers (usually  Restylane or Prevelle).  Pure fat transposition procedures can be prone to relapse of lower eyelid fat bulges as the... more

For your specific problem I would recommend transconjunctival blepharoplasty with a pedicled fat repositioning with adequate arcus marginalis release. The pedicle maintains circulation to the fat graft, which is contoured to the tear trough deformity and secured with absobable pull-through sutures, usually 3-4... more

Though it is difficult to tell from the picture you provide, it appears that you have fullness just above the tear trough that makes it appear to look deeper.  Speaking generally, when encountering a situation such as this, it can be approached with either surgery or fillers.  To answer your... more

Looking at your pictures, I would suggest a very conservative approach. From the pictures you do have some fat herniation, which causes there to be worsening of the dark circles. I would caution about rushing into a lower eyelid surgery, as your eyeball position is slightly forward. This may cause a very... more

Tear Troughs can cause us to have a very tired look. Luckily, they can be greatly improved.  Restylane works beautifully to camouflage the tear trough. It  takes approximately 30 minutes for a well trained cosmetic physician to perform this complex injection. It lasts approximately 18 months time.... more