Can I Get Rid of my Deep Tear Troughs Permanently? (photo)

I have deep tear troughs under my eyes, i can wake up morning having had a good sleep and still they are there, they are not dark as such but never fail to make me look tired; i was wondering what are my options for permanently removing these dark troughs. Also i have asymmetrical eyes my right eye droops and i would like to know what is available to cure this also and can both be done in one opp?

Doctor Answers 14

Treatment of tear troughs deformity

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Frequently, deep tear trough grooves at a young age are hereditary and not necessarily due to descent of cheek soft tissue or remodeling of bony mid-face. Various fillers are used to improve or correct this deformity but they are usually temporary. Permanent or semi-permanent fillers such as Artifil and Silicone have the risk of long-term deformity from filler misplacement or migration over time. Fat is another option, but there is a risk of irregularity and asymmetric resorption. The only predictable and permanent correction that I would advise in this case would be a tear trough implant placed through a transconjuctival incision. Please consult a qualified facial plastic surgeon to review your options in persons.

Cambridge Facial Plastic Surgeon

Can I Get Rid of my Deep Tear Troughs Permanently?

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Everyone has facial asymmetry and you are no exception. Facial asymmetry makes one side of the face to look different than the other. In your case, it is the right side that is slightly shorter than the left. This will, therefore, change the relationship between left and right of the face. Tear trough deformity is the result of loss or lack of volume of the cheek area. In young patients, it is the smaller cheek bones that do not support the lower eyelid area adequately and are situated slightly posterior to the brow. This will cause protrusion of the lower eye fat and/or tear trough deformity. The long term procedure is tear trough implants that can be placed through intraoral route in order to avoid eyelid incisions.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

Can I Get Rid of My Tear Troughs Permanently? Fat Grafts May Fill In Under-Eye Hollows

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The hyaluronic-acid based fillers such as Restylane Silk and Volbella can do an amazing job of filling out under-eye troughs. Though they are not permanent, some can last for up to 2 years or more. If you really do want a surgical solution, fat grafts could fill out your hollows, making you look more rested. Fat grafts are permanent, though there will be some loss of fat after your procedure, as not all of it survives. As for the asymmetry in your eyes, I don't think it is significant. Talking to a facial plastic surgeon about your needs can help you decide on a course of action. I hope this helps.

The Management Of Tear Trough Deformities

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It's not unusual for patients with tear trough deformities to request plastic surgical consultation. When this situation arises, a variety of treatment options exist to treat this condition. These include surgical procedures that release the arcus marginalis and the use of injectable hyaluronic acid fillers that minimize tear trough deformities.

It's extremely important to individualize the treatment of tear troughs. For this reason, the specific procedure chosen will depend upon the patient's anatomic findings and aesthetic goals.

It's important to realize that lower eyelid filler injections are very effective for treating tear trough deformities, but don't represent a permanent solution to this problem. For this reason, when patients want a permanent solution, other options need to be considered.

Procedures that offer a more permanent solution include fat grafting, tear trough implants and procedures that re-position fat pads. The exact procedure chosen will depend upon the patient's physical findings and aesthetic goals.

For these reasons, it's important for patients with tear trough deformities to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Tear trough deformity

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I would recommend talking things through with an orbit or tear trough expert to discuss your options. Non-surgically, you can approach this area with Restylane, Restylane Silk, or Belotero. These are fine HA fillers that aid in improving tear trough deformity. An additional option is fat transposition during lower eyelid blepharoplasty. This differs from fat transfer from other areas of fat on the body which can give a sausage like appearance.  Best of luck!

Sean Paul, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Tear trough deformity treatment.

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Tear trough deformity treatment is best done with Juviderm since fat usually leaves the patient will a "sausage" in their lower lids unless done with a lower blepharoplasty. Though it only lasts 1 year, it should have minimal problems.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Tear troughs or dark circles

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The answer is yes.  There are nonsurgical options (fillers) and surgical options (fat, implants) available.  Consult an oculoplastic surgeon to determine what is best for you.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Permanent Options For Tear Trough Correction

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There are few options for truly permanent tear trough correction. These include the use of fat  or actual synthetic tear trough implants, each of which has its own advantages and disadvantages. Fat injections are a natural material and less surgical in execution but they may resorb and can end up with some irregularities. Implants are smooth and are permanent but they must be precisely placed and thus require an open eyelid approach. Prior to consideration of either of these, you should have a synthetic injectable filler placed first to determine if the effect it creates is what is desired. If so, you can either repeat the synthetic filler as it resorbs or consider the permanent options.

Mild eyelid problems

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First off, like most folks, you are your own worst critic.  On the photos you supplied, I do not even appreciate that your "right eye droops", so I certainly would not recommend any treatment for what is likely a quite minor, and perfectly normal, asymmetry.  There is mild prominence of the tear troughs which could be managed with an HA filler (I like Restylane over Juvederm in this location) if you are so inclined.  But I think you need to ease up on criticizing your appearance.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Tear trough and ptosis

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Thank you for the question. Tear troughs can be treated with fillers. The droopy eyelid can be treated with one of several eyelid procedures. See an oculoplastic surgeon for evaluation and treatment discussion. 

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.