Undereye teartrough / ligament deformity. Best treatment option to to fix the bulge and hollows? (Photos)

Question

Over the past year I've tried to fix mid face undereye volume loss with a few things - I got mid cheek filler and prf (1 session) then co2 under my eyes (mid cheek and co2 done in March) it helped with the hollowness but now I have residual edema underneath my eyes and they actually appear darker...Seperately prior to any filler, I have a bulge that appears when i smile next to between my eyes and nose. Injectors have said it can't be fixed with filler and looks like a ligament deformity so can someone tell me the best surgeries youd recommend. Im 29 and hoping to fix the bulge and hollows. Would a temporal lift help my overall face?

Kadir Berat Oyur, MD · Answer

Based on your description and the images in image, it looks like you are dealing with a naturally tight tissue anchor combined with true volume loss and some fluid retention from your recent treatments. A lower blepharoplasty with fat repositioning is usually the best surgical option for this because instead of just removing fat, a surgeon releases that tight internal ligament causing the crease and smoothly shifts your natural fat pockets down into the hollow tear trough area, flattening the bulge and filling the shadow at the exact same time. Alternatively, a surgeon can surgically release that tissue anchor causing the smile bulge and use micro-fat grafts from your own body to fill the hollows, which avoids the swelling issues that temporary fillers can cause. Just keep in mind that a temporal lift won't help you here since it pulls the outer brow and corners of the eyes upward and outward, completely missing the central mid-face, tear troughs, and the bulge next to your nose. The best move is to let your March treatments completely settle, and then see an eyelid or mid-face surgical specialist so they can feel the tissue and tell you exactly what is possible for your anatomy.

Undereye teartrough / ligament deformity. Best treatment option to to fix the bulge and hollows? (Photos)

Answers (1)

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