Would you recommend Infraorbital rim implants, fillers, or fat grafting for hollow tear-trough? (photos)

Question

The hollowness and projection of my lower lid is something I've been very insecure about for a very long time — it makes my already large eyes appear to bulge (before asked about a thyroid issue, I have checked on this and it has been dismissed. Nothing is wrong with my thyroid, simply genetic). I was wondering what my best option would be to fill/soften this contrast? Could I also get an estimate for your recommended procedure? Thank you!

Jason J. Hall, MD, FACS · Answer

From your photographs, it does not appear that you have a significant tear trough deformity.  The puffiness under your eyes is from a slightly enlarged orbicularis muscle (the muscle that gives your eyelid some shape and helps it close (among other things).  A very small amount of Botox in this area can help smooth this out, but it is not a treatment that should be performed by an inexperienced injector.  Consult with an experienced, board-certified plastic surgeon for an in-person examination to help guide your decision.

Inessa Fishman, MD · Answer

I do not see a tear trough in the photos posted, and your eyes have a beautiful, youthful appearance.  If you feel bothered by the fold of tissue in the lower eyelid (the small bulge immediately underneath the lash line), this may be better addressed with a tiny dose of muscle-relaxing neuromodulator such as Botox.  Some people have a bit of hypetrophy in the circular muscle that encircles the eye and allows one to squeeze the eye shut; this hypertrophy may result in a bulge in the lower eyelid.  Neuromodulators, or muscle-relaxing injections, temporarily improve the appearance of this.  Seek out an experienced injector with a keen understanding of facial anatomy and thorough experience with neuromodulators for an evaluation; an injector should perform an exam and test the strength of your eyelid if neuromodulator injection is indeed contemplated.  Good luck!

Robert T. Buchanan, MD (retired) · Answer

You could use either an infraorbital rim implant or a filler like Juvederm Voluma or Radiesse to make your eyes look less prominent. However, this would be very tricky and hard to get just right. I normally feel very comfortable doing this. However, in you, I personally would be very worried about making a very natural and beautiful eye less attractive. You do not have a "tear trough." What you have is a slightly elongated eyelid that fits your face (what is visible in the picture). Instead of seeking surgery, learn to accept yourself. Understand that everyone is different and it is the differences that make us unique and beautiful in our own right.

Would you recommend Infraorbital rim implants, fillers, or fat grafting for hollow tear-trough? (photos)

Answers (3)

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Would you recommend Infraorbital rim implants, fillers, or fat grafting for hollow tear-trough? (photos)

Answers (3)

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.