I have a question about fat injection on tear troughs - which is best?

Hi thanks for sharing your question. Both fat as well as fillers can be used to correct tear troughs. Fat fill gives volume which is permanent and the stem cells in it helps to improve the pigmentation if any. But about 20-30% of fat which is injected may get absorbed and  more than one sitting maybe required to achieve the desired results. Hope this will help you. 

Thanks for your question. 
Either fat or filler may be used to inject in the tear trough areas to improve hollowness. Each one has advantages and disadvantages. 
First, it is necessary to determine that volume is needed in the lower lid/tear trough areas. The patient needs the right anatomy- hollowness without significant skin excess and without herniating fat in the area. Usually the patients are younger. 
Once it has been determined that volume is needed and nothing else, then deciding on fat vs fillers is necessary. Fat has the advantage of being permanent and natural, and the stem cells in fat are thought to help with the dark pigment in some patients. It has the disadvantages of requiring a surgical procedure, is more expensive, and the success can be variable. Patients will sometimes need multiple rounds of fat grafting to get the desired result. 
Filler, on the other hand, is easy to inject, can be done in the office in a few minutes, has little downtime, and is relatively inexpensive. However it is not permanent, and there is risk of contour irregularities that may not smooth out over time. 
There is no greater increase in risk by injecting fat compared to filler, in my opinion. The main safety point is to be sure the injections are done with low pressure and in the correct plane in order to avoid the complication of an embolus which can cause blindness. This can happen with either fat or fillers. Fortunately this is very rare but does illustrate why it is important to get this done by a physician who understands the anatomy and injection technique. 
Best wishes, 
Rohit Jaiswal, MD
Plastic Surgeon, Las Vegas, NV 

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Fat grafting and fillers can be used to fill the tear trough area.  Fat grafting is a permanent method to add volume, while fillers may dissolve over 9-12 months, depending on the type of filler.  Both can have a nice result when good technique is used.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon