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

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.

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.

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. 

An injectable filler is probably your best option short term, and long term would be fat transfer or implants. 

Hi,

Thank you for your question.

Upon viewing your pictures, I agree with the other doctors that the best nonsurgical way to go would be through fillers, such as restylane or juvederm. However the best option wuld be surgery with a midface lift plus/minus fat injections.  Your decision really depends on whether you want to go the surgial or non-surgical route. I would recommend consulting with a board certified ocuplastic surgeon.

I wish you the best!

Dr. Speron

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.

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.

You can't win, you can't brake even, and you can't get out of the game.  You have big eyes.  There are no permanent fixes.  Big surgeries expose you to the risk of being wrecked.  Please do not get wrecked.  A better option may be maintenance treatment with fillers.  The lower eyelid position is lower that the left lower eyelid if that is what you are speaking of regarding eyelid asymmetry.

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.

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!