Under eye tear trough dropping? (Photos)

I'm very thin, yes, but haven't changed weight in last few years. The fat under my eye keeps dropping, now to the malar region of my cheeks. The tear troughs are also uneven. I saw fine lines at first, and thought I was getting lots of wrinkles there. The problem, which I'm now realizing from old photos, is the fat from top of orbital bone has been disappearing. There is just skin there. I want to get filler there. What should I do? I'm scared of fat transfer there!

Doctor Answers 6

Under eye tear trough dropping?

Hello, and thanks for your question and photo. I do think you're a great candidate for placement of a hyaluronic acid filler in your tear trough (i.e., under eye) area. In this area I prefer Restylane, but there are other fillers that work well in this location. This is one of my favorite procedures to perform, as patients instantly look more rested and younger. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht. 

Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Volume Loss Midface/ Tear Troughs

Thank you for your question. With time, we all see volume loss combined with the gravitational decent of our muscles. Combining Voluma for volume, and Belotero for tear troughs is a common request. If you decide you like the look, a permanent malar/submalar implant can be done.

Best wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 29 reviews

Tear troughs under eyes

thanks for the question and photos. Over time we all lose volume in our faces. Also the fat that remains descends with gravity. For you, volume for tear trough is needed. This can be done with fillers or fat grafting, both have risks and benefits but both are safe. Lower lid surgery may be needed to tighten the skin or use lasers/peels. Lots of options so seek a consult in person. Good luck 

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tear through filler

Thanks for your question. You are a very good candidate for dermafiller for tear through . 

I usually combine it with few sessions of either laser or RF . 

Please consult with an expert physician 

Reza Akef, MD
Toronto Physician
5.0 out of 5 stars 2 reviews

Tear trough options

From your photos it would appear that you would do well with a small amount of volume in both the tear troughs and the mid face. For example, start with 1 syringe Restylane or Belotero to split between the two tear troughs, and 1 syringe Restylane LYFT for the mid cheek so that it lifts up to meet. You might end up using 2 Restylane LYFT to get the volume you need, that is better determined at your consult. Be sure to go to someone with A LOT of experience with tear trough injection, and that they use microcannula technique to deliver the fillers. 

Fat transfer...I don't perform this. My clients who have had it done have not been overall positive about it. It is of course more costly. Not all the transfered fat necessarily survives and results can be lumpy, uneven...some centers are combining fat transfer with PRP and Stem Cells to enhance results. Again, at added expense...but I would go that route if I were going to do it. 


Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 11 reviews

Under eye drooping

From your photos it appears you could greatly benefit from filler injection under the eye.  I prefer Juvederm or Voluma to the area you are showing.  Neat thing is that you get an instant lift that will take away that tired appearance.  Fat transfer is also commonly done there and is a safe alternative .  Hope this helps.

Dr. ODell

B. Edward O`Dell, MD
Florence Physician
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.