Procedures for Deep and Wrinkly Tear Troughs?

I am considering getting fillers injected into my tear troughs. Are there any suggestions for procedures you would make based on the attached photographs? Also, anything I should do before or after the filler to make the skin plump and pretty? I have done extensive research on under-eye creams and such but nothing really seems to stand out. I don't have "bags"; I have an absence not a presence.

Doctor Answers 7

Dermal fillers can be a great option for filling up the tear troughs

Depending on the laxity of your eyelids and prominence of the tear troughs, dermal fillers such as Restylane can be a great option for this condition. However, lower eyelid surgery may be needed if the laxity of the skin is too great or there are fat herniations present.

I hope I was helpful.

Austin Dermatologist
5.0 out of 5 stars 3 reviews

You can improve your lower eyelid tear troughs with Injectable Fillers.

You appear to have typical lower eyelid grooves that can be minimized with an Injectable Filler treatment. You should consult a dermatologist or facial plastic surgeon experienced in the art of filling this delicate area and see some photos before proceeding. I wouldn't start any new creams right before an Injectable Filler treatment. You could discuss skin care with your physician at the time of your consultation.

I've attached a link to my Injectable Filler photos for your perusal.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Restylane, Juvederm or diluted Radiesse works good for deep tear troughs

Filling in the area with temporary fillers like Juvederm or Restylane @ $550 per syringe and usually needing about 2 syringes works good and should be done in 2-3 sessions over 1-2 weeks time so as not to get lumpy if done all at once. Diluting Radiesse with lidocaine also works well and tends to last longer than the other fillers @630 per syringe.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Good filler candidate


You look like an ideal candidate for the use of Restylane to fill your periorbital area. I do not recommend any pre-treatments. It is best, however, if you avoid medications listed by Dr. Aldea in his response. In addition, I have found that there may be more bruising in patients who have had alcoholic drinks within a few days prior to the procedure.

Dr. Torkian

Behrooz Torkian, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 17 reviews

Retylane for the tear troughs - the "non-surgical" eye tuck (blepharoplasty)

Restylane is a reasonable option for the tear trough. There are few products that actually thicken the skin with Retin-A being the most studied. Caution must be exercised in use of Retin-A around the periorbital region.  

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Injecting the tear troughs

 You look like a good candidate for Restylane to the tear troughs.  This would add the missing volume that you need.  It doesn't treat the skin but the volume will be nice.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tear Trough Filling - Filling an Absence to create a Presence

Properly placed Restylane in the Tear Trough (Nasojugal lines) will correct much of what you show in your cropped photograph. You do not need to pre-treat the areas with anything but MUST be off all pills and dietary supplements which increase bleeding times (such as Aspirin, Advil, Alleve, Vit. E, Ginger, Garlic, Nuprin etc).

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 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.