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

Question

Male, mid-20s. Looking for a possible remedy for my deep tear troughs I've had since childhood. I'm wondering if a lower Blepharoplasty with fat repositioning would be a good or viable move for me? even if I don't have eyebags with fats to reposition. Are there some other ways? I'm also considering fat transfer instead but I've heard a lot of people end up with lumps of fat. Making things visually worse. Any opinions and suggestions would be much appreciated. Thank you!

Gary M. Horndeski, MD · Answer

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.

A.J. Amadi, MD · Answer

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.

Nelson Lee Novick, MD · Answer

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".

Thomas A. Mustoe, MD, FACS · Answer

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.

Zoran Potparic, MD · Answer

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.

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

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Answer: Would lower blepharoplasty help with deep tear troughs?

Answer: Would lower blepharoplasty help with deep tear troughs?

Answer: Lower Bahamas for tear through trough deformity

Answer: Lower Bahamas for tear through trough deformity

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

Answers (5)

Answer: Would lower blepharoplasty help with deep tear troughs?

Answer: Would lower blepharoplasty help with deep tear troughs?

Answer: Lower Bahamas for tear through trough deformity

Answer: Lower Bahamas for tear through trough deformity

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.