Other Than Lack of Fat, Can Weak/low Cheekbones Cause Tear Trough in a 20 Years Old?

I have deep tear trough and dark circles since I was born. I read that lack of fat under the eyes can cause it, but I also read that low and weak cheekbones can also create a hollow under the eyes that runs below the zygomatic bone that is right under the eyes (my case). If that's true, can cheek implants help? I've tried Restylane injections but they were of little help. Can implants make the hollow disappear or at least make it look fuller permanently?

Doctor Answers 3

Cause of tear trough in a young patient

The tear trough is the junction between thin eyelid skin and thicker cheek skin.  It is more prominent in some patients than others.  If the maxilla area is flat, cheek implants can augment the tear trough and maxilla.  Cheek implants are inserted through an incision above the upper teeth and placed directly over the maxilla, under general anesthesia.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Hollow eyelids

Dear ckstarlet,

  • It is usually from a loss of volume, like flatter cheeks or or bulging fat from the eyelids
  • You may need a little more Restylane if it helped a bit, usually in your age group Restylane looks fantastic
  • Fat injections may help you give you volume you want without the implants
  • The best thing to do is to visit a few surgeons for opinions on what kind of results you want

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Tear trough causes

I would say that in most cases, the development of the tear trough deformity is due to a lack of fat.  It is possible to have this deformity be caused from heredity as well.  A weak cheek bone can influence the appearance of the tear trough in some people.  Without a picture of you, it's impossible to tell you if a cheek implant would help with your issue or not.  There are also implants that can be placed deep to the tear trough that can help with that area directly. 

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.