What Are Some Possible Causes of Tear Trough Deformity? 5 Months Post-open Septo/rhino (Photos)

Prior to surgery, my eyes looked youthful. I had faint under eye circles, but the darker coloring was mostly near the inner corners and faded out. Since surgery, I have darkness, bags, & hollowness. I look angry. Bags wrap around my eyes, corner to corner, aging my face. Nose is wider now (spreader graft) & seems to push into my eye area. Not allergies, thyroid or weight loss. What may have caused this? Osteotomies? Still swelling? Can narrowing/revision help? I just don't look like me anymore.

Doctor Answers 7

What Are Some Possible Causes of Tear Trough Deformity? 5 Months Post-open Septo/rhino

I still see residual edema/swelling in the area so that makes the deformity appear worse. Either wait or try fillers. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Swelling In Nose After Rhinoplasty

Hello. From your picture you do not appear to have a tear trough deformity, rather swelling of the nose causing the bags under your eyes. If this is the case, the swelling should subside but it could take up to one year to completely resolve. To be sure that this is the problem you need to be evaluated by your doctor.

Jaime Perez, MD
Rhinoplasty Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Tear Trough

After seven more months, you may need some cosmetic work around the eyes & orbital regions.  After seven more months, hopefully, a lot of your current issues will improve.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tear troughs after rhinoplasty?

You definitely had tear trough deformity prior to your rhinoplasty and it is also obvious that you have deeper tear troughs now.  That could be either age related or overall weight changes, but it also possible tear troughs can become more apparant after osteotomies.  It is impossible to know and it wouldn't make any difference as to what treatment would be best, which is filler injections into the tear troughs, although I cannot rule out the role for lower blepharoplasty from just looking at your 2 dimentional photos.  See an oculoplastic surgeon for proper evaluation and treatment options.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

What are the Causes of Tear Trough Deformity.(swelling of the lower eyelid) . 5 months After Rhinoplasty

The probable cause of the fullnes of the lower eyelid tissues after you Rhinoplasty Procedure are;

  • The nasal surgery also causes a significant amount of swelling not only on the nose but also in surrounding structures: i.e.  upper lip, cheeks etc.
  • The fluid from the swelling can also accumulate in the fat pads of the lower eyelid, causing the enhanced tear trough that you are concerned about.
  • The dark circles are a result of an accumulation of bruising in the fat pads which is seen as dark circles.
  • Bottom line: significant surgery and prolonged swelling

The good news is that condition will improve over time

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 20 reviews

Tear trough deformity and rhinoplasty

I do not see a change in your tear trough. It does appear that you have more swelling along the fat pads of the lower eyes in your after photo, perhaps giving the appearance that your tear troughs are deeper. Most likely this is related to the surgery, especially if lateral osteotomies were performed. 

I would give it time, as you may still have residual swelling.

Good Luck

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 112 reviews

In general, lower eyelid grooves do not get worse after Rhinoplasty Surgery.

I read your concerns and reviewed your photos which are quite limited for evaluation:

I have not seen worsening of lower eyelid grooves in my rhinoplasty patients. It's conceivable your lower eyelid bags may be more noticeable after your rhinoplasty surgery, but we cannot see the before and after photos of your nose.

Feel free to re ask your question with good quality, full-face before and after photos for the RealSelf community of experts to evaluate.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

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.