Very deep tear troughs, do not want filler. Surgical or non surgical route? (Photos)

Question

Hello! I am 27, have had very deep tear trough since I was a child. My lower eye bags have always bothered me. I know tear trougha are a tough area for doctors. I am not willing to get traditional filler. I got quoted at 12k for a lower bleph. I’m curious what yalls opinions are. Are my eyebags and tear trough bad enough to justify surgery? Or do you think I can improve it non surgically? Was thinking sculptra, or prp/prf. But worried that might be a waste of money and not really do anything. My eye bags themselves don’t bother me much, but this deep tear trough line really bothers me. Any advice or personal experience appreciated. (I have heard horror stories of tear trough filler and fat transfers, let Me know if you have any experience with these)

Zoran Potparic, MD · Answer

In cases like yours,  deep tear through deformity can be treated with transconjuctival lower blepharoplasty. This will improve TT without need for skin removal. In person consultation with a board certified plastic surgeon familiar with this procedure is recommended. Good luck.

Erin Smith, MD · Answer

Hi, thanks for your question! In general, options for tear trough management include 1) Dermal fillers such at Restylane 2) Fat grafting (usually taken from the abdomen, thigh, or gluteal region) and 3) Lower blepharoplasty with fat repositioning. Surgical treatments tend to be more durable, but some patients find it helpful to trial filler (which is shorter lasting) before comitting to a procedure. As always, I recommend consulting in person with your physician before making any treatment decisions. Hope this is helpful!

Thomas Spalla, MD · Answer

Since you haven't done anything yet to this region, I would recommend that you start slowly.
PRP/PRF/PRF gel are all great options for the undereyes. The risks of doing these are very low, the results are nice but not overdone, in the right hands, and can also help in collagen regeneration.

Fillers, which you noted you want to avoid, can be done, but a very smooth and thin one must be used for this delicate area. Despite the expectation that fillers (HA) will dissolve, they don't always, so that must be considered when using these anywhere but especially the unforgiving undereye region.

Fat can be a nice option but since you haven't done anything yet, I wouldn't recommend jumping into this potentially permanent option.

Sculptra is not intended to be used in this area though some providers use a more dilute solution for this off-label indication. I wouldn't jump into this option yet either.

Very deep tear troughs, do not want filler. Surgical or non surgical route? (Photos)

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Very deep tear troughs, do not want filler. Surgical or non surgical route? (Photos)

Answers (3)

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Everything you need to know about Eyelid Surgery

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