Would a lower Blepharoplasty be able to help with deep tear troughs? (Photos)

Deep tear troughs are caused by the orbicularis muscle being tightly adherent to the bone. Fat transfer die by itself if done skillfully can help and look very natural, but the best improvement is through a lower blepharoplasty through a trans conjuctival approach lift the muscle off the bone, reposition fat and also do some fat transfer. There is no visible scar and eyelid shake will not change.

You don't have big fat bags under the eyes, so you wouldn't want to take any more fat out. The tear trough can be effectively filled in younger people with either filler or fat transfer. If it is performed correctly, the fat that is injected is almost like fluid or a filler, so the chance of lumpiness is very minimal. Be sure to see a facial specialist for consultation.

Either fat transfer or fat transpotion can be used to correct tear trough deformities - the correct choice for you will depend on your in person exam and the expertise of your surgeon. If searching for a non-surgical treatment, you could also consider treating the area with a dermal filler.

Yes, a lower blepharoplasty with fat transposition can help fill in the tear trough. I would recommend you do this first before doing fat injections.

Best Wishes,

Gary Horndeski, M.D.

I perform lower blepharoplasty with fat repositioning for the majority of my patients that have lower eyelid fat prolapse. In your case, I would say that it would be counterproductive: You do not have significant fat prolapse and if we pull any fat out of your eye socket to try and fill the tear trough, it would leave your eyelid looking more hollow. And there is no guarantee that the fat will stay.

Your options to volumize the tear trough are the following:
1. Filler- Not a great long term solution as it can create swelling and can migrate
2. Fat grafting- works great when it works, but it can be unpredictable in its take and lumpy bumpiness is a risk
3. Tear trough implant- this is my favorite option as it is predictable and reversible. The size and shape of the implants are limited however, so it may not be perfect for everyone, but it is the best available option, in my opinion for your anatomy. I've provided a link below.
Virtual consultations are available.

Your problem is a very common one in my experience. Before jumping into expensive blepharoplasty with its surgical risks, risk of scars, and prolonged post-operative downtime, you might wish to consider a consultation with an experienced, board certified cosmetic dermatologist filler injector expert.
The upper cheeks region is a major support for the under-eyes. When there is volume deficit in this area, the under-eyes typically develop bags and hollows (as in this case). In the hands of an expert injector, the use of an appropriate robust HA volumizing filler, properly injected to replenish volume In the upper cheeks, can serve to smooth the transition between upper cheeks and lower lid regions thereby diminishing the hollows that disturb you. In the hands of an expert injector, treatment typically takes about ten to fifteen minutes to perform, yields immediate results, and engenders little to no significant downtime. For these reasons, this happens to be one of my most popular filler treatments. So, hope this helps, best of luck and remember to "keep it simple".

Yes, lower blepharoplasty, in your case transconjuctival would be appropriate procedure to correct tear through deformity. Considering that your problem appeared very early, it is very likely that you have an underlying malar (cheek bone) deficiency which could be addressed with cheek augmentation with implants or even fat grafts. In person consultation with a board certified plastic surgeon familiar with these procedures is recommended. Good luck.