I'm 23 and Have Tear Troughs That Don't Respond to Restalyne; my Surgeon Says I Have Edema of the Cheek? (photo)

I have gone in twice in the past two months for Restalyne injections in my tear troughs, which I've had my whole life and am sick and tired of looking at, but to no avail. My doctor said he did what he could, but I have edema of the cheeks so I'll just always have them. I don't want to believe it is true. Would cheek implants change this?

Doctor Answers 4

Restylane and tear troughs

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Sounds like you should meet with a different provider, and get a second opinion. Because you have fuller cheeks, doesn't mean you aren't a good candidate for filler, it just means you need specific injection techniques and/or more product.

I'm 23 and Have Tear Troughs That Don't Respond to Restalyne; my Surgeon Says I Have Edema of the Cheek?

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Photo not very helpful. Best to seek second opinions in person from doctors in your city or area. Best to you. 

You need a more experienced injector.

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I have patients do get 1 ml of under eye Restylane split between the two lower eyelids and look great.  I have others who require 3 ml of Restylane under each eye.  You also probably need some deep cheek volume in the superior buccal fat space.  My dad like to say if the butcher tells you the meat is bad you should listen.  He is telling you that this is the best he or she can do.  It is time to find a more talented injector.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Tear trough treatment

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It is a difficult situation. You are very young so I would not suggest any surgery at this time. However, using filler in the cheek bones can lift the cheeks up enough that it might efface the tear trough. If that does not work then a lower eyelid approach midfacelift will probably fix the issue.

You also have to look closely and make sure you don't have a color mismatch of the lower eyelid and the cheek. If the eyelids are darker than the cheek, you will benefit from a chemical peel to lighten that area.


Dr. J



This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.