Why do my tear trough fillers not last more than 6 weeks?

Question

My injector is a renowned plastic surgeon in London uk. I have had one syringe of juvederm under each eye &several top ups. I have also had voluma in my cheeks to try and fill everything out as I have a very slim face. My injector said it's something to do with (I think she said the septum bone is in the way) the filler seems to, in a few weeks go to either side of the deep groove and not stay in the actual groove making the hollows very visible. Why does my fillers not last very long?

Jonathan Kulbersh, MD · Answer

This is difficult to determine, but some people do metabolize filler faster than others. A permanent solution to eye bags is lower blepharoplasty.  The results should last about eight to ten years. You should also develop an anti-aging regimen with your facial plastic surgeon that will include skin care and laser treatments to maintain the results of your blepharoplasty and keep your skin looking healthy and young as you age. I hope this helps.

Aldo Guerra, MD · Answer

I'm not sure why your filler did not last. Some people do have a higher metabolism, but I'm wondering if you just had an undercorrection. I suggest you get a second opinion and consider a different filler. The most reliable filler in our practice for the tear trough has always been Restylane. I would also suggest a cannula technique for better placement into the groove.Good luck. Dr. ALDO

Mary P. Lupo, MD · Answer

I love Juvederm. But, Juvederm is my least favorite HA filler for the tear trough area, mainly because of its well-deserved, notorious reputation for delayed and persistent swelling. All HA fillers last around a year in this less mobile area. Your history is quite unusual, so I would seek a second opinion, optimally with an oculoplastic surgeon.

Leonard Grossman, MD · Answer

It is my personal belief over  the last 23 years that such hyaluronic acid fillers should not be used in the tear trough area. They do move by the action of orbicularis oculi muscle and they tend to move towards the nose, they also create a great deal of Tyndall effect and start to look like fatty, blue bags under the eyes. My recommendation has always been the same, fat grafting. It provides permanent and natural results. Good luck from New York City

Justin Harper, MD - Account Suspended · Answer

Hi Eliza,Hyaluronic fillers don't last long with patients who metabolize fast. However, because the area has very thin skin overlying it, it shouldn't be overfilled. You have 2 surgical options (right along the alley of your doctor) - a blepharoplasty or fat graft.Voluma works well but it doesn't seem effective in your case. You may want to try Restylane Lyft and Sculptra. Sculptra works great because you own collagen is induced to grow. Although results are not immediately visible (unlike with HA fillers), collagen builds up over time and the results last longer.All the best, Justin Harper, M.D.

Why do my tear trough fillers not last more than 6 weeks?

Answers (5)

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