What would you recommend for my tear troughs? (Photo)

Question

Hello! I am 23 and have had these tear troughs under my eyes for my whole life (genetic on my dads side) and was wondering what kind of and how much filler doctors would recommend? This would be my first experience with any filler so I’m pretty nervous but it’s been my biggest insecurity since forever, thanks so much!!

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

Nima Shemirani, MD · Answer

Hi @Grace189. It would be difficult to determine how much tear trough filler you would need virtually. Typically, half a syringe (0.5 cc) to a full syringe ( 1 cc) is appropriate. It is best to under correct than over correct the tear trough area. I have my patients return 2 weeks post injection to see how the filler is settling and for adjustments to be made if necessary. I recommend going to a licensed practitioner with experience while treating this area.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. Hyaluronic acid dermal fillers are an excellent option for treating hollowing and discoloration under the eyes while making them appear more refreshed and awake. By administering the ideal amount of filler around the tear trough, the skin will be lifted to create a smooth, supple appearance. 
Restylane or Belotero are often used to treat this area, though the precise formula and dosage that is right for you should be determined by the performing injector. In my office, we use a micro-cannula to inject this area, which minimizes bruising and swelling and ensures the smoothest outcome. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can discuss your concerns and answer any questions you may have.

Dilip D. Madnani, MD, FACS · Answer

The picture is limited in view however- a combination of check and UNDEREYE filler will be your best options.   The cheek filler will volumize your midface and the UNDEREYE filler will sit nicely over the cheek filler to give you a refreshed appearance.

Nelson Lee Novick, MD · Answer

From the photo provided, tear troughs and hollows appear to be the predominant issues, and for these kinds of issues fillers have been used with gratifying results for over three decades. Age-related volume loss in the cheeks, which is somewhat difficult to adequately evaluate in the photos here, can be a major contributor to the development of both tear troughs and bags. If so, then a robust HA filler augmentation of the cheeks can not only improve the cheeks, but secondarily improve the tear troughs and hollows. If still necessary, following this, a cohesive, low viscosity HA filler can then be used directly in the tear trough regions for further smoothing. Which specific fillers and how much can best be determined from an in-person examination that allows for direct manipulation of the involved tissues. Make sure to consult with an experienced, board certified cosmetic dermatologist and be sure to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck and Happy New Yea

Camille Cash, MD · Answer

From the limited photo it appears you may benefit from under eye filler.  This can add volume and improve facial contours.  I've included a video I hope you find helpful.  See an experienced injector near you to learn more.

Charles Cheng, MD · Answer

Please consult an experienced injector in person for the best results. Choose your provider carefully as this is one of the more difficult areas. Good luck.

Glenn Vallecillos, MD, FACS · Answer

The tear-trough/under-eye is a complicated area for injections. It would be in your best interest to discuss potential complications with your injector and make sure to see as many before and afters as possible. It's essential that your injector is well-versed in that section of "injection anatomy"; the nose and under-eyes are two of the most risky parts of the face to get injections (unless it's from someone who does them all the time; or has tons of experience doing so).

Robert T. Buchanan, MD (retired) · Answer

Your genetic tear troughs are just a variation of those that occur from volume loss. Treatment is use of a thicker (high G-Prime) filler like Juvederm Voluma placed on the bone just above the muscle but below the orbital ligament. Unfortunately the majority of injectors do not understand the anatomy or how to do this. Make sure you select an expert who does.

What would you recommend for my tear troughs? (Photo)

Answers (9)

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