Success Rate of Tear Troughs Fillers?

Question

I hear nothing but horror stories and see less than pleasing results with the tear troughs fillers. What's the key to success here?My doctor, wanting to demonstrate how wonderful it would be, and how great the difference would be, had me cover one eye, and then injected some water under the other; he then had me look in the mirror, at each eye separately.  It looked awful.I know that proper technique is key, but this is all good in theory. Do you have patients who are honestly and truly satisfied with this procedure and would do it again?

David Hansen, MD · Answer

Filling in the tear trough areas can be tricky and you have to expect some lumps and bumps for a little while. It is best done over 3-4 sessions over a few weeks with either Juvederm or Restylane ($550/syringe for 2-3 syringes) or Radiesse diluted with lidocaine ($830/ syringe @ 2 syringes). Even with a few little bumps that eventually disappear, most patients still like the end results which can last from 6-9 months better than the deep hollowness under the eyes. Bruising is also to be expected so cover up with good makeup.

Nima Shemirani, MD · Answer

Hi @CuriousInLA! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area.  Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular.

Eric M. Joseph, MD · Answer

The lower eyelid groove, or "tear trough", is the groove that forms between your lower lid fat-bulge and cheek. Filling these grooves lead to gratifying results for my patients and me.
I've attached a link to a photo demonstrating this technique.
I hope this is helpful for you.

Steven J. Pearlman, MD, FACS · Answer

Most patients who get fillers for the tear trough are happy. Unfortunately, I have found that from 20 to 25% may see some lumps. If you compare the before to the afters, the eyes with the lumps still often look better but now patients are using magnifying mirrors to examine their eyes. I prefer using Restylane for this area. There is more initial swelling but after 2 days it is stable for many months. What you might read about unhappy patients really stems more from the fact that unhappy patients post more and happy patients are less likely to spend time searching for a solution; they already have it.
You should seek out a physician who has a lot of experience in filler treatments for this delicate area.

Nina S. Naidu, MD, FACS · Answer

The tear trough is a very difficult area to fill, as the skin is very thin and small bumps become very obvious. It requires a significant amount of experience to achieve natural results, but when you do get a good result, it looks great. I would recommend seeking a plastic surgeon or dermatologist who has extensive experience in this area. While most of us are comfortable with fillers, a small number have expertise with the tear trough area. Good luck, /nsn.

Success Rate of Tear Troughs Fillers?

Answers (6)