Is It True That Fillers Are Not for Tear Troughs?

It’s not unusual for patients with tear trough deformities
to request plastic surgical consultation. When this situation arises,
hyaluronic acid fillers are very effective for treating this problem. Under
these circumstances fillers can minimize tear troughs and ultimately improve
peri orbital aesthetics.It’s
extremely important to individualize the treatment of tear troughs. In some
patients the lower eyelid skin is extremely thin and for this reason injectable
fillers aren’t always indicated. In this situation injections may be
accompanied by nodules and bluish discoloration.It’s
important to realize that lower eyelid filler injections can be very effective
for treating tear trough deformities but aren’t for everyone with this
condition. For this reason it’s important that patients with tear trough
deformities be evaluated by a board certified plastic surgeon. This surgeon
should be able to formulate an appropriate treatment plan for this problem.

Hi- thanks for your question! Fillers can be an excellent way to manage under-eye hollowness. I am especially fond of Restylane for this purpose. Make sure you chose an injector that is an expert in the anatomy of this area to ensure a safe and effective treatment.

Hi there! 
Fillers can be successfully used to restore and improve the tear trough area providing experienced hands. Personally I use a soft hyaluronic acid based dermal filler for this area. Make sure you contact a highly trained aesthetic practitioner with plenty of experience with the tear trough area as it is a complex area. 
Hope this helps!
Dr Rupert

If the primary cause of your under eye dark circles is skin hyperpigmentation, then you will not be a suitable candidate for tear trough dermal fillers.
Most hollow tear troughs are mainly due to volume loss and suitable for treatment with a dermal filler, so I would suggest you seek an opinion from an oculoplastic surgeon who performs a large volume of tear trough dermal filler treatments. 

This question was posted several years ago. Today, there is a Health Canada approved filler for the tear troughs: Teosyal Redensity II. It is designed for the area to fill out the undereye hollows. I’ve performed the procedure many, many times with great results.

Facial fillers are not the best choice for tear troughs.  This area has inherently thin skin and can easily show the fillers underneath the skin.  They can have a lumpy or blueish appearance (tinseling).  This is probably the area most prone to unsatisfactory results or complications and for this reason fillers are generally avoided or used with extreme caution.  This is not a good solution for severe tear trough deformities.  The best option is something called a mid face lift which repositions the fat in the area and gives a more permanent soft result.

When it comes to choosing between a plastic surgeon and a dermatologist it would depend on the problem.  Problems with the skin cancer, hypo-pigmentation, crepe like appearance of the skin, fine wrinkles, superficial problems etc are all easily handled by both but as the problem gets deeper or more severe a plastic surgeon is the better choice as they are trained in surgery for at least 6 years while a dermatologist may have little to no training in cosmetic surgery.  Severe problems as described here typically need a surgical solution. 

The dark shadows beneath the eyelids, especially the inside half, can be challenging to improve. Use of the HA fillers such as Restylane and Juvederm can be successful IF performed very carefully, meticulously, and placed properly (usually deep to the slender muscle layer that is there). It is not unusual for some bruising to occur. These injections are best performed by the more experienced physician. Keep in mind that skin color and thickness, aged skin, and presence of fat all can contribute to the under eye shadows and circles.   DRC

  

Fillers can be used to soften the tear trough area. The choice of filler is important> I prefer the hyaluronic aced fillers because of their consistency, clear nature, and reversibility. Especially in this area, the skin is very thin, lumps may occur and it is nice to be able to inject a hyaluronidase which can smooth the area in a day or two.

Autologous fat transfer is an excellent filler, however I prefer to perform this procedure in the operating room.

Fillers can be an effective means of softening the tear trough. Knowledge of anatomy is critical here because superficial placement of the filler can create visible asymmetries as well as a Blueish tint to the skin.

Filler must be placed in the proper anatomic plane, preferably using an HA filler such as Juvederm.

Tear trough injections are great and really soften the dark circles associated with this problem. There are several products that are easily instilled in this area. Second Opinion?? Absolutely!