Best way to get rid of tear troughs? (photos)

I've had deep tear troughs since I was a small child, now at 23, I find that they make me look much more tired and exhausted and I'm not a fan of covering them up with make up everyday. What is the best way to get rid of or lessen them?

Doctor Answers 8

Eyelid

Fat from inside your orbit could be transposed into the tear troughs and filling the hollowness. A variety of innovative techniques may be employed, depending on the clinical situation. 

Fillers can help

Hyaluronic acid fillers can help help a lot. They will help fill up the hollowness. Skin care and lasers can supplement the result.

Eyelid Surgery

Thank you for your question. Tear troughs can be improved with the use of hydraulic acid fillers, and your result can be supplemented by lasers. I suggest that you consult in person with a board certified facial plastic surgeon. Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

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Fat repositioning blepharoplasty vs fillers

Dear GrazzleThere are three options for treating this hereditary problem of lower eyelid fat prolapse, depending on patient's anatomy, age, preference, and financial situation:1. Lower lid blepharoplasty with fat repositioning:  This technique repositions the prolapsed fat (bags) into the hollow area just below it, in the transition zone between the eyelid and the cheek. This is a permanent surgical procedure that addresses the anatomic problem directly and definitively, using your own fat volume to address the tear trough hollowness. The downside is that it is a higher cost up front to the patient. However, in the long run, it will likely be more cost effective as repeated injections of fillers (Restylane) over 5-10 years will end up costing more for the patient. 2. Hyaluronic Acid Fillers- Use of this in office injectible product to the hollow directly below the fat bulge can help camouflage the fat prolapse and improve the transition between eyelid and cheek. This is a less expensive option in the short run, but over 5-10 years, will probably cost more than the surgical option. As mentioned by other surgeons, Restylane is likely the best choice of filler in this region. I like using this option for mild-moderate cases, and usually as a short term solution. Repeated injections eventually will lead to an unnatural bogginess in this region, so its not a fantastic long term solution in my opinion. 3. Fat transfer- This uses the patients own fat (harvested via minimally invasive liposuction techniques) to augment the volume loss in the face, namely the tear trough in this case. I prefer this technique in older patients who have global facial volume loss which would require a lot of volume. Using this technique in younger patients may be more risky because as metabolism decreases in the middle age years, the transferred fat may also grow leading to too much volume. In your case, I would recommend option 1 or 2. This would require an in person consultation so that we can accurately assess the anatomy and also have a discussion of your preferences and long term goals. I've included a link to give you examples of repositioning fat in younger patients. 

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 32 reviews

Under eye hollowing

Hello there,You may be a good candidate for under eye fillers. It's important for you to find a surgeon that has extensive experience performing lower lid fillers and also eyelid surgery.  Best of luck, 

Voluma for Tear Troughs

Hi there, we do tear trough treatments several times a day and the product we use for cases like yours is Voluma. It is FDA-indicated to last up to two years. The results with Voluma can be excellent and there is virtually no downtime, most of my clients go right back to their day afterward.

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 15 reviews

The state of the art treatment is under eye hyaluronic acid filler.

I have one of the largest practice of this in the country.  I only like one product for this: Restylane.  It has the advantage of holding up for a very long time.  For someone your age, you can reasonable expect treatment to last about a year or more.  The key is finding a hight artful and skilled under eye injector.  Do not go to a medical spa for this service.  Often it is an oculoplastic surgeon who is good at this.  The dermatologist are often not comfortable treating close to the eye.

Kenneth D. Steinsapir, MD
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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.