Los Angeles Doctor Recommendations for Injectable Fillers in Tear Troughs

I had a lower eyelid bleph and have hollowness above my tear trough-close to my eyes. I'm in my late 30's and my skin is very thin in this area. I'm looking for a doctor who is comfortable injecting a filler close to the eyes. Thank you.

Doctor Answers 3

Fillers for tear trough injections

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We typically use Restylane around the eye area rather than Juvederm or semipermanent fillers because of the long-term danger of lumpiness.  Some of the permanent fillers and fat injection are particularly dangerous and must actually be revised with surgery if permanent lumpiness forms.

The surgeon should talk with the patient about what is causing the problem.  Eye bulges, for example, may be difficult to conceal with filler alone, so surgery may actually be better for the patient.  Cheek drooping may be best treatable with a cheeklift.

For straightforward tear troughs, this can generally be accomplished in one or two settings, depending on the patient's filler history..

As to which surgeon you choose, there are many fine doctors in the area.  However RealSelf doctors are not a bad place to start your search.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Tear troughs fill is nicely under local anesthesia.

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Tear troughs fill is nicely but need to be done slowly such as 3 weekly sessions a little at a time.  Radiesse diluted  does good for most patients and lasts about 1 yr.  I am in the los angeles area at 310-273-8006.


dr hansen

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Tear Trough Correction - Fat Injection NO Fat Grafting Yes

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I do not inject filler under the eyes. Instead, I use fat grafting. The results can be seen in the before and after images I've posted to Realself

The under eye area is very delicate and leaves little margin for error.  I have seen some people with hyaluronic acid fillers in the under eye area with a nice result. I have seen many more with a puffy unnatural results that distorts the look of the entire face I know a number of physicians who once used fillers for correction of the tear troughs but have abandoned this technique because it is so unpredictable. Fat grafting (not fat fat injection) when expertly administered by  a plastic surgeon with experience and expertise using specialized equipment can provide beautiful, natural looking and lasting results. My gallery of fat grafting before and after images includes dozens of images of fat grafting to tear troughs, under eye hollows and hollows in the upper eye area.

I have yet to see a physician with dozens of images of any other filler placed in the tear trough area. When making a permanent change to the face, I think patients must view many, many photos of the procedure they are considering Two or three photos just isn't enough to make a patient confident about results. 

We do use a lot of fillers in my practice. Juvederm, Restylane and Voluma are all excellent  products for the appropriate indication. But none of them are FDA cleared for use in the tear trough or under eye area. I do not believe they belong there. 

The most important thing to remember is NEVER to have any material injected with a needle into the area around the eye. The needle can inject material into an artery which can embolize the central retinal artery, resulting instantaneous, permanent loss of vision in that eye.  Fat grafting is administered with a blunt cannula  and not a needle. 

Looking at many, many great before and after images is a must. But it is just a start. Take your time checking the background and training of your physician. Ask other medical professionals about a doctor you are considering, check your state medical boars. And finally, find a plastic surgeon who really listens to you and your concerns.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

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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.