How to Best Treat Volume Loss In Tear Trough/Cheeks? (photo)

I feel like I've lost a certain amount of volume in my mid face. I'm not sure, however, if what I'm seeing is considered the eye trough area or cheeks... Ultimately, I'm unsure which filler would be best seeing as I'm not sure what area would treat the problem. Any recommendation would be appreciated -- eyes or upper cheeks -- radiesse or juvederm..? Thanks!!

Doctor Answers 4

Sculptra is a great filler for cheek revolumenization

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Sculptra is a great, long lasting filler to replace the loss of volume of the central cheek areas that occurs with age due to loss of collagen, fat and bone.  The effects can last for years.

Austin Dermatologist

Filler for tear trough and mid face region

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Hi LisaRic. Your concern regarding the loss of volume in the tear troughs and cheeks is what drive many patients to seek a filler solution.  You have several options to consider:

1) hyaluronic acid fillers as Juvederm, Restylane,  Perlane etc. which are effective for up to a year.  These are all reversible if you don't like the results.

2) Radiesse, for the cheeks, which will last for 18 months.  Not reversible.

3) Sculptra, a volumizer that stimulates your body to produce collagen with results that last for two years.  Not reversible.

4) Fat grafting which can last for years. The fat is taken from your body and injected into your face.  You will need a skilled surgeon who has done many of these procedures.

All of the above options can produce excellent results in the hands of a skilled physician.   The physician you see can help you decide which product(s) to use and areas to fill. Good luck!


Joseph N. Togba, MD
Oakland Plastic Surgeon

Fillers in tear trough

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I am a big fan of fillers in the tear trough and often place restylane in this spot.  Be prepared for some bruising afterwards for a few days.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Fillings in a Tear Trough

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Dear LisaRic,  Thanks for the question.  You have a lot of options for addressing this area and there is no one right answer.  Every injector has their favorite techniques that work for them and these are the ones they are most comfortable in using.  

From your photo, it appears you may have lost some volume in the mid-face (the cheeks) and also in the tear trough which is part of the normal aging process.  One option would be to use fat to fill in both the cheeks and the tear trough.  This technique is one that requires a bit more precision than an off the self filler since you need the fat to survive and also placed in very small amounts with each pass to avoid lumps and clumps.  The good news is that there are many very well trained surgeons to choose from before proceeding.  The advantage of fat is that it is your own tissue and it lasts a long time.  The disadvantages are that it does require a second surgery site, the fat has to survive when it is transferred, if you do not like the result and want it reversed, it is much harder to get out than to put in.

Off the shelf options include using a HA product such as Juvaderm in the tear trough and cheek or using the HA product for the tear trough and Radiesse or Sculptra for the cheeks.  

Please consult with a board certified injector-usually a plastic surgeon or a dermatologist-who can provide you with the options that will best address your concerns.  Hope this helps.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 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.