Tear Trough implants? (photos)

Question

Hello, I want to fix my tear trough deformity. I do not want to get injectables, so it is either implants or bleph. The reason I do not want injectables is because I want a permanent results or nothing at all. Please advise what I should pick, implants or blephteroplasty. Fat transfer is also an option, but its not entirely permanent. I do not have time going to the surgeon multiple times in my life. Want to just get it once, and move on with my life, or get nothing at all.

Kenneth D. Steinsapir, MD · Answer

It is an old and invasive solution and the field has moved away from this.  The reason is that occasionally it is associated with significant complications.  Other options have proven much better.  The number one option is hyaluronic acid filler that lasts over a year and sometimes longer.  If there is an issue with it, it can be modified or removed with enzyme.  You face and mid face change over time.  There is no single solution that will last forever.

Sarmela Sunder, MD · Answer

I personally would advise against tear trough implants, as there could be issues with it, depending on placement and size mismatch. In addition, because your face will continue to change (with bony resorption and fat loss), I doubt that even the implants will be a try permanent solution. Another option to consider include fat repositioning through a lower blepharoplasty. However, based on your photo, it is difficult to see whether you would have adequate fat to allow for effacement of your tear trough. Fat  transfer is another option, but it can be unpredictable.

Shlomo Widder, MD · Answer

Dear Jobra,    Thanks for submitting your picture. Fillers, which are considered non invasive cosmetic procedure, are very popular and quite common in my practice, since they are very safe and need to be done only twice a year. Think of them as makeup.  I have no experience with tear trough implants, however the risk with them is size mismatch and possible injury to the infra orbital nerve.  A good option that worked well in my practice is partial MACS lift, that elevate the cheek tissue upward , filling up the tear trough and the lid cheek junction indentation. This procedure can improve on your condition for years.    Consult with experienced board certified plastic surgeon who are familiar with the MACS lift technique.                            Best of luck,                                          Dr Widder

Mehryar (Ray) Taban, MD, FACS · Answer

I don't think blepharoplasty will be helpful since you have hollowness, not true bags/bag.  Tear trough implant is a permanent option. Another semi-permanent option is filler injection, which last a couple of years. Another option is fat injection.  See an oculoplastic specialist.

Matthew Bridges, MD, FACS · Answer

Even with surgery, the results are not permanent.  It is unrealistic to expect to get a procedure done that lasts forever and does not require follow up with the doctor.  Fillers are easy to do, are reversible, and usually last more than a year in the tear trough region.

Barry L. Eppley, MD, DMD · Answer

Permanent tear trough augmentation can be done using preformed, semi-custom or custom made implants. I have done tear trough augmentation using each of these implant methods and they each have their own advantages or disadvantages. The key is to get implants that fit the bone precisely and are not oversized. They are placed through a lower blepharoplasty incision.

Darryl J. Blinski, MD · Answer

I know of no PS doing tear trough implants. The standard of care are fillers or nano fat grafts.......

Tear Trough implants? (photos)

Answers (7)