Do I need SOOF lift to correct my tear trough? (photos)

Question

I`m 38 yo and developed "tear trough" issue a couple of years ago. To address this I got Perlane 1ml to each side 4 months ago and it was ok for the first month, but now I feel like swollen in the area and my troughs look even worse then before the procedure. Does that mean that fillers are not good for me and I should probably opt for SOOF lift instead? I would appreciate your comments

Jason Emer, MD · Answer

It appears you have swelling from the filler and if you had come to me I likely would reverse the filler with an enzyme injection and then redo your filler properly.  If this wasnt good enough, which I think given your anatomy it would be, then I would consider surgical options.  Radiofrquency treatments such as thermage and sublative work very well in this area too.  Best, Dr. Emer.

Robert Sleightholm, MD · Answer

The post injection photos show swelling of the malar (cheek) fat.  Filler injection of the tear trough can be very effective and of long duration.  There are specific fillers for the tear trough (vobella, restylane fine line) that absorb less fluid resulting in less swelling.  The tear trough should only be corrected to about 80% to avoid overcorrection.  As mentioned above filler in this location lasts a very long time.  Hyaluronidase injections removes the filler.  It is very important not to inject into the malar fat pads as they swell and persist for a long time.  I do not believe that you have sufficient periorbital fat to warrant surgery.

Katrinka L. Heher, MD · Answer

No you do not need any surgery. Your swelling in your cheeks is due to the perlane and can be reversed with hyalronidase.  After that the tear troughs may benefit from a Restylane injection and maybe you may need volume placed in your cheek with radiesse or voluma.  The good news is thar all of this can be corrected in the office with small procedures. Good luck.

Sean Freeman, MD · Answer

midcentury, you need to let the filler wear off and see a specialist who is familiar with fillers to this area and the "SOOF lift blepharoplaty". I cannot tell if you are developing malar bags early in life or are simply reacting poorly to the injection. I'd wait at least another several months before seeking any intervention. As the inventor of the "SOOF lift" I've seen quite a few younger woman who benefit from the procedure but I do not know solely from your photos if you would be one of them. Good luck!

Sanaz Harirchian, MD · Answer

Hi midcentury. Thanks for your question. Tear trough deformities are typically due to either 1) lower eyelid fat herniation, with shadowing under the fat and/or 2) volume loss in the lower eyelid/cheek region. Volume loss is addressed by volume replacement, typically with fillers or fat from your own body. The hyaluronic acids are great fillers for the face. Some do absorb water, increasing in volume over time. This may be happening if you are noticing increased swelling in the region of injection. If this is the case, then the hyaluronic acid can be dissolved.  I would recommend an in person consultation for a proper examination. Good luck. Best, Dr H

Ronald V. DeMars, MD (Retired) · Answer

Based on the photos I think I would steer you away from surgery for now and opt for fillers. But the tear trough is a notoriously difficult area for fillers so make sure you find a highly skilled injectionist.

Do I need SOOF lift to correct my tear trough? (photos)

Answers (6)

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