Which would be better for me now -- fillers along the tear troughs or a lower eyelid lift? (photos)

OK, I'm convinced that I could really benefit from an upper eyelid lift (although I think I was over-Botoxed and it pushed my lids down even further). But I'm wondering if I need a lower eyelid lift, too, or if I can do as well with fillers for a few more years? I don't have large bags, but I do have dark circles. And are fillers dangerous to the eyes? Thanks!

Doctor Answers 12

Filler Versus Lower Blepharoplasty

Since you have only a modest amount of bulging lower eyelid fat, good lid position, and minimal skin laxity, you are a good candidate for a non-surgical solution such as an HA filler. If you are leaning toward a more long-term solution, you would also be a good candidate for a transconjunctival lower eyelid blepharoplasty with repositioning of the fat into the tear trough region. If you do choose to have lower eyelid surgery, I would also suggest surgery on your upper eyelids. It is a straightforward operation that heals quickly and would give new life to your eyes. A combination of upper blepharoplasty and filler in the lower eye area is also a great option. I agree that Botox can age the appearance of the lower eyelid when it is used in heavy handed fashion at the lower outer quadrant of the eye. Good luck and best wishes.


Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 99 reviews

Fillers or lower blepharoplasty

A basic principal in surgery is to operate only after non-operative options have been tried. You are a good candidate for Juvederm to camouflage your lower eyelid bulges. The bulge will still be there, but it will be harder to see. You can probably postpone surgery for several years

Ben Lee, MD
Denver Plastic Surgeon
4.5 out of 5 stars 25 reviews

Lower lids

When patients have very minimal fat prolapse in the lower lids with a moderate tear trough, fillers are a very effective option. They are also very safe when done by an experienced injector. It might be a better bet right now to stick to the non-surgical options for your lower lids. As always, an in-person consultation with an experienced surgeon is essential.

Kenneth E. Morgenstern, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Upper and lower eyelid surgery

The primary goal of upper eyelid surgery is to remove the hooded excess skin creating the tired look. The incision is located in the upper eyelid crease and the excess skin is removed to refresh in the upper lids. The primary goal for lower eye lid surgery is to remove a conservative amount of fatty deposits in the lower lids creating the puffiness look.  The incision is located on the inside of the eyelids, also known as a trans-conjunctival approach. For many examples of both upper and lower eyelid blepharoplasty, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Fillers or eyelid surgery

Hi Houston,
I would do the upper and lower Blepharoplasty to give you the best result but if you want the upper eyelid and restylane in the lower eyelid trough you can do that.  The darkness will improve with the lower eyelid surgery when the periorbital fat excess is removed.  Wish you the very best

Wafik A. Hanna, MD
Hinsdale Facial Plastic Surgeon
4.3 out of 5 stars 12 reviews

Lower Blepharoplasty

The use of injectable fillers in the lower eyelids is not without its own set of problems including creating bags and even making them look worse if too much filler is put in. Since you are already having an upper blepharoplasty you may consider a transconjunctival lower blepharoplasty at the same time to get rid of the orbital fat that has prolapsed outward. Your pictures do not show that much if any lower eyelid skin needs to be removed.

Fillers or surgery for dark eyelid circles

It is difficult to evaluate the source of your dark circles from a photograph.  However, fillers will probably not cause visual problems as long as they do not cause a lot of bleeding or an infection.  They may not be effective for dark circles.  If there is a moderate or more fat protrusion, a lower blepharoplasty may be better.

Elliott B. Lavey, MD
Danville Plastic Surgeon
5.0 out of 5 stars 11 reviews

Which would be better for me now -- fillers along the tear troughs or a lower eyelid lift?

I think fillers would do well for you for quite a while as long as you do not lose a lot of weight.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Lower lids

ckw7, I would recommend a "SOOF lift blepharoplasty". I've been using this approach for over 15 years and it has vastly improved my results in the lower lid. You can find plenty of info on the web about the procedure. Fillers tend to mask lower lid aging and look unnatural and do carry a risk of causing one to go blind (very rare). Always see a seasoned facial plastic specialist. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.8 out of 5 stars 45 reviews

Eyelid surgery vs fillers

Both fillers and eyelid surgery can give you good results as you only have a small amount of prolapse of orbital fat. Even though fillers can be done with less downtime there are still significant risks injecting around the eyes with the biggest risk being blindness. Lower eyelid surgery is more invasive but has more lasting results especially when done earlier. 

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 31 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.