How to restore volume on hollow eye corners (tear trough)? (Photos)

Getting a good assessment and understanding treatment options of the lower eyelid and mid face is fairly complex.
In a youthful face, the contour around the lower eyelid is snug and the area just below, is plump and full of volume.
As we age the two areas create opposing changes. Fullness develops in the lower eyelid as the Peri orbital septum becomes a weak , allowing for protrusion of the lower eyelid fat pads(there are three of them).Just below this volume is lost in the tear trough and mid face.
Since there are two changes, usually happening at the same time, it’s important to first differentiate if bulging of the fat pads in the lower eyelid is primary or a loss of volume just below that. FullNess of the fat pads in the lower eyelids is best treated with a lower eyelid blepharoplasty.
Volume restoration in the mid face can be done using, fillers, and can also be done with fat grafting, a mid facelift or the placement of implants.
Getting the assessment correct and the best treatment is not always easy or straightforward. The key is always finding the right provider.
Different providers will have different views on how to approach this part of facial aging.
in regards to volume restoration fillers are ideal because they are precise, predictable, and forgiving if you don’t like the outcome.
Fat transfer can be permanent, but does not have the advantages fillers do.
Fat transfer is inherently unpredictable, imprecise, and can be unforgiving if patients are not happy with the outcome.
Many people may be apprehensive at the idea of having implants. The mid facelift is fairly invasive, and has a fairly long recovery with swelling and potential bruising.
The two most important variables are understanding your own candidacy, or in other words, understanding the problem and which treatments are likely to work best The second is finding the right plastic surgeon to work with.
To find the right provider, I suggest having multiple in person, consultations with plastic surgeons in your community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of the previous patient who had similar facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. When reviewing fat grafting results, make sure you understand the timeframe of when after pictures were taken. Early fat grafting results can look very impressive, but do not necessarily represent long-term results. After pictures should be taken a minimum of three months from the date of surgery preferably six months or longer.
Continue having consultations until you feel you’ve met the right provider for your needs.
I suggest avoiding virtual consultations and avoiding traveling, long distances for elective surgical procedures.
Best,
Mats Hagstrom, MD