Should I consider tear trough filler along with cheek filler?

At least from the one cropped photo provided, ti would appear that the use of a robust, HA volumizing filler would not only help to contour a more oval, heart-shaped face, but would likely secondarily improve the under-eyes without even the need for additional filler there. I encounter this kind of situation very frequently in my practice and very often find that no additional tear trough filler treatment is required. The use of a robust HA filler for the cheeks can often yield durable results of up to 1.5 years. I stopped using fat injections a very long time ago. Admittedly, the idea of using one's own fat and the promise of permanent results is enticing. However, the reality is that much of the fat, once separated from its original blood supply in the thighs, abdomen or buttocks does not surprise. What's more the fat injection therapy is relatively expensive process and engenders downtime, since fat must withdraen with large cannulas from the donor sites and injected via large cannulas into the recipient sites. And finally, any fat that does survive this process retains the characteristics of the area from which it is taken, meaning that with the passage of time belly fat will develop a midriff bulge, any fat transplanted into the face that did survive may also develop bulges. You would be wise to consult with a board certified cosmetic dermatologist filler expert. Best of luck.

Tear trough and cheek fillers often go hand in hand because they can complement each other to produce a balanced, natural-looking result. Here's why:
1. Tear Trough Filler: This treatment is used to address under-eye hollows and dark circles. It can freshen up the eye area and make you look more rested.
2. Cheek Filler: This enhances the cheeks' volume, providing a youthful contour to the face and improving the appearance of the under-eye area.
When the cheeks lose volume due to aging, it can make the tear troughs look deeper. So, adding volume to the cheeks can lift the skin, reducing the appearance of the tear troughs. Conversely, if the tear troughs are filled without addressing volume loss in the cheeks, it could lead to an imbalanced facial appearance.
However, every individual is unique, and what works best for one person may not work for another. It's important to have a detailed discussion with a professional cosmetic doctor or dermatologist about your specific facial anatomy, your goals, and expectations. They can provide personalized advice on whether you should consider both procedures.

You could benefit from both, based on your photo (or fat transfer if you prefer)


Best of luck !

Dr Haworth

It's difficult to make a recommendation with the limited photo. It is a good idea to analyze adjoining features when considering filler to help blend facial contours. I encourage you to visit with an experienced injector to discuss your concerns and learn what will best help you address them. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Filler is an option for treating this area, however I recommend laser or microneedling as a first step. Tightening the skin will be helpful and filler may not even be needed afterward. Another reason to do tightening as a first step is that energy-based treatments can partially dissolve fillers. Laser (Sciton Erbium YAG profractional or ablative) will have excellent results. The Sciton halo will have nice results and have a faster recovery. If you are not willing or able to manage the downtime/recovery care associated with laser treatment, then RF microneedling (such as Morheus8) can give decent results with minimal recovery care.

Thank you for your question.
Many times, the primary contributor to volume loss in the tear trough or lower eyelids is volume loss in the cheeks, even though it may not seem as obvious. Correction of the cheek is important first, as the cheek serves as the foundation to support the ligaments on the lower eyelid. Often times, correction of the cheek will also decrease the amount of tear trough filler needed. This is critical because there is not much room under the tear trough and too much filler in the tear trough can eventually sag. Furthermore, the lower eyelids have many blood vessels and can bruise more easily. After the volume loss in the cheek is corrected, then some filler can be placed on the tear trough.

Photo is not a lot to work with but based on what I see I would fill cheeks first and then revaluate. The way the skin under your eyes will drape differently and you might not feel that you need under eye filler or might need a lot less.

Though posted 1 photo to close up and need frontal full face photo... I recommend combination but limit amounts injected. Or try 2 sessions of injections about 1 week apart. Best to see in person evaluation by injecting MD only!

Since I’ve been using fillers, such as hyaluronic acid, fillers since 1994, I have been telling people not doing inject these fillers into the tear trough. There can be quite nasty and pretty much permanent. I have always been a big advocate (for 30 years) of fat grafting. In the right hands fat grafting produces natural and permanent results. Fat grafting can be done anywhere on the body, starting from the top of the head and down to the smallest of the pinky toes. Plus, there is practically no Recovery. I hope this answers your question, and good luck from New York City Plastic Surgery.