What is the best treatment option for tear trough correction? (Photos)

Question

Hello. I like my eye bags, but I don’t like my deep tear troughs line. It’s genetic and Iv had it since I was a child. I need help choosing a good option for my anatomy. Fat repositioning: Iv considered this option, but my plastic surgeon said he is seeing more and more cases of festoons. So I’m hesitant to go this route. Lower bleph: I don’t think this is right for me, because I don’t want my eyes looking sunken and hollow. I personally like my lower eye bags and think they look natural. Even when my eye bags are flat and not puffy, my tear troughs line is still very deep and prominent. So I doubt removing fat will help. Fat transfer: I’m so unsure about this one. Lots of mixed reviews when it comes to the tear troughs areas. Fat can get lumpy or take unevenly and can sometimes take multiple sessions to see final result. I also can’t decide if nano or micro fat is the right way to go? My other concern is I have a small medial cheek line. If possible, whatever I do for my tear troughs, I’d like it to be able to correct my medial cheek line as well, so I don’t have to treat them seperatly. What do you suggest doctors? Iv already spent a lot of $ on consultations, only to still be torn between so many decisions and uncertainty.

Zoran Potparic, MD · Answer

You seem to have small cheek bones what is the mayor reason for early onset of tear trough deformity, discoloration, tired look. A correction should include periorbital fat grafting to enlarge bones and transconjuctival lower blepharoplasty to correct TT. I hope this helps.

Kenneth D. Steinsapir, MD · Answer

Sometimes surgeons try to steer patients away from one type of surgery to another. Sometimes when they say a certain procedure is not good,  what they really mean is that they are not good at the particular procedure. I strongly advise you decline free fat grafting. This is like injecting scar tissue. It will likely make your festoon worse rather than better.

Transconjunctival, arcus marginalis release surgery is perhaps the most commonly  performed lower blepharoplasty technique. It is technical but extremely predicable in the right hands, However, transposing your eyelid fat help the little eyelid bag and the tear trough, It in no way helps the festoon, The festoon is cause by  a loose plane of skin and muscle. This must be addressed separately with a what is known as an orbicularis resuspension performed through a skin incision made below the eyelashes. You are one of those individuals who would benefit from both approaches. I call this a front and back lower blepharoplasty.

Thomas A. Mustoe, MD, FACS · Answer

Fat transfer will reliably improve that area and in 20 plus years and over 1000 cases I have not seen festoons, but definitely have with filler.  For the most complete result lifting the muscle off of the bony rim surgically through a transconjuctival all lack combined with fat transfer has had the most success in my experience but fat grafting by itself will improve it

What is the best treatment option for tear trough correction? (Photos)

Answers (3)

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