Genetic Tear Trough Problems? (photo)

Restylane to the tear troughs is probably as good a treatment option as is available.  I would start with one syringe divided between both areas.

 

Kenneth Hughes, MD Los Angeles, CA

Looking at your photos, it appears you would benefit from a treatment with Restylane, which is the better option for the tear trough. It takes a very experienced injector when using Restylane for the tear trough, and I would recommend doing your homework and finding a qualified physician if you choose to have the treatment. In general, a board certified dermatologist, plastic surgeon, or facial plastic surgeon are all great choices. I hope this helps, and I wish you the best of luck.

Try Restylane injected by a doctor who is very experienced with doing injections using this filler. It is different from Juvederm in that it has a thicker consistency. Thus, it must be injected with great care to produce the best result. Both Restylane and Juvederm may cause a bruise like effect called tyndall’s effect. Radiesse on the other hand would not. The video shows an example.

 

From the photo you've posted, it certainly looks like you'd benefit from a dermal filler to this area. I suggest consulting in person with a well-trained and experienced injector to discuss your options for best correction.

Of the two Restylane and Juvederm, yes, Restylane is much, much better.  The reason is that Juvederm is "smooth" which is probably marketing speak for "runny." This tendency for Juvederm to spread after injection is helpful for inexperienced injectors.  If they make a lump or bump from treatment, the material tends to spread resolving the issue.  However, this same tendency to spread or runny is a very bad thing in the lower eyelids.  Product that runs tends to collect at the top of the cheek.  This can make a very unattractive ridge.  For this reason, highly experiences injectors like myself prefer Restylane.  Perlane is even thicker and this can make getting a smooth result very hard in a thin lower eyelid like yours.  Finally, it is important that you find a local injector because it is often necessary to have the service adjusted after the initial treatment to get the best possible result.  In Denver, I can recommend Dr. Michael McCracken but there are many other highly qualified individuals in Denver as well.

Yes see a few docs who do Restylane for that area. I recommend a series of visits using ONLY drops of the HA filler to slowly improve the appearance. 

Before doing anything surgical I would try a filler such as Restylane or Belatero.  Even if you do not get a full correction it might be a great improvement and make you happy. I have seen several disasters with fat  implant and would stay away from that.

Yes, tear troughs can be treated with restylane but it has to be done very carefully.  Go to a good injector.  Be aware that bruising is pretty much a given when injecting this area.

Your tear-troughs are very deep and clearly skeletal in nature.  A tear-trough implant would provide you with substantial correction that would exceed anything you can get with a soft filler.  The implant effectively makes your bone fuller throughout the upper cheek and into the lower eyelids.  Soft tissue fillers such as fat and Restylane won't be able to provide the amount of correction you need.  In addition, Restylane would be temporary and fat transfer ends up being temporary in a high percentage of patients as well.   For the amount of filling you need, using soft tissue fillers simply won't work.  If you were to correct that area properly for the non-smiling condition, when you go ahead and smile, all of that soft tissue filler will crowd into a "pudgy" roll under your eyes and in your upper cheek.  The implants won't do that, when you smile, the soft tissues slide over the top of them, just like they slide over the bone currently.

The tear troughs in your case as you have indicated have some genetics that predispose you to it - whatever the cause, they are treatable with either Restyane or autologous fat transfer. Some practitioners also use Juvederm in this area. Autologous fat transfer may be the best option for you and may give you a longer lasting outcome.