Tear troughs after lower lid blepharoplasty, is this normal?

Question

I had lower lid blepharoplasty April 2014. Loved the results but now have tear troughs, is this normal??

Andrew Campbell, MD · Answer

A lower blepharoplasty should not be able to cause a tear trough. You may have had the early stages of a tear trough that has worsened over time. Discuss your concerns with your surgeon. Filler or fat can be used to improve them. See someone with extensive experience since filler or fat in that area can be a little tricky.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

J. Phillip Garcia, MD, FACS · Answer

Hello,
Usually, tear trough formation is part of the aging process.  In all likelihood, they were either present or starting when you had your original surgery three years ago. There are several solutions for tear troughs and they range from actual surgery to autologous fat injections to filler injections.  Each procedure has pros and cons.  Make sure your surgeon talks about the best option(s) for you. 
Regards,

Mitesh Kapadia, MD, PhD · Answer

There is often some hollowing in the lower eyelids after lower blepharoplasty surgery. This is easily corrected with filler injections along the orbital rim to help blend the eyelid-cheek junction. Find a doctor who specializes in this procedure to help optimize your surgical results. Properly placed fillers in the lower eyelids often last several years.

Brian A. Pinsky, MD, FACS · Answer

Thank you for your question.  It is difficult to tell the answer to your question without examining you in person and comparing your result to your pre-operative photos.  In general, part of the standard lower blepharoplasty is excision of the excess fat of the lower eyelid compartments.  Over excision of this fat can result in hollowing of the lower eyelids and the appearance of a tear trough deformity. Options for treatment would be filler injection vs. fat grafting.  Both are excellent ways to address this issue if it is present.  I recommend an evaluation by a board certified plastic surgeon.  Good luck!

Christopher Saunders, MD · Answer

Definately review pre-op pictures to assess this area before surgery. In my experience, this area is not typically worsened by surgery, but improved.
Hollowing can occur after this operation. Fillers are often the first line of treatment and have high success rate. Too much of the product can make it look fake and unnatural.
Review this concern with your doctor and with the before pictures.
Best of wishes!
Dr Chris Saunders

Steven Wallach, MD · Answer

You more than likely had tear troughs to begin with but probably did not notice them before the surgery. Often precise filler placement can improve this.

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case.  The development of a tear trough is normal after lower blepharoplasty.  With time, your cheek begins to descend causing the hollowing you see under your eyes.  Luckily, fillers like Restylane Silk, Volbella, and Belotero are excellent options to improve the transition between your eyelids and cheeks.  Because the delicate skin of the eyelids requires expert care, consider a surgeon-injector who has experience both with blepharoplasty and filler injections around the eyes.  Good luck!

Tear troughs after lower lid blepharoplasty, is this normal?

Answers (7)

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