Fat vs filler for tear trough correction?

I am in need of tear trough correction due to aging & genetics. In reading the recommendations on here, it looks like Restylane is the preferred method. However, it seems to me that having an opaque filler would be more effective than a clear one. Since fat is opaque & filler is not, wouldn't fat give better results?

Doctor Answers 7

Injectables Fillers

I personally prefer Restylane to the tear trough region for hollowness. From my experience injectable fillers are efficacious and provide a more predictable outcome then fat. I would recommend to seek an experienced board certified plastic surgeon who is also experienced with injectable fillers to determine your candidacy.

Dr. Daniel Ritacca


Chicago Oculoplastic Surgeon
4.3 out of 5 stars 18 reviews

Dark Circles, Eyelid Wrinkles/Bags -- Restylane, Voluma or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

I am currently loving using voluma to the tear troughs although other fillers like restylane, belotero can be used as well as fat.  I suggest seeing a physician for a formal consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Restylane or Fat for Tear Trough Correction

I prefer Restylane or Belotero for tear trough correction.  Depending on your facial anatomy either product is extremely effective.  I don't like fat since it has many more complications. Best, Dr. Green

Restylane for tear troughs

Restylane and other HA fillers such as Volbella Juvederm (not Voluma) are suitable for the tear trough area. These fillers are placed under the muscle layer, and just on top of the bone, displacing volume. HA fillers are excellent for tear troughs because fine work can be achieved with them. Fat is good for large areas of volume loss, fillers best for small areas where intricate work is needed. 

All the best

Dr Davin Lim 
Laser and aesthetic dermatologist
Brisbane, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Restylane is Safe and Effective for Tear Troughs

Thank you for sharing your question. Restylane is the best filler for tear troughs. It is very safe and effective. Restylane lasts about 6 months. Fat placement works well, but there is a higher risk of complications. Fat can be permanent. Make sure your doctor is experienced with multiple modalities for treating eyelid conditions. Good luck.

Restylane for tear troughs

When filler is injected in the tear trough it is typically injected deep, under the muscle.  This way you get a natural augmentation and lifting of the skin. If the filler is injected too superficially, there is a higher risk of getting blue discoloration (Tyndall effect) and swelling.  In my opinion, Restylane injections are less invasive and safer than fat injections in this delicate area.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Fat vs filler for the tear trough

Filling of the tear trough area can create a more youthful, less tired look.  However, it is an area that is often treated incorrectly by many injectors.  It is important to seek out an expert injector when considering treatment of this area.  Fillers injected into this area correctly are not visible (the colorless portion is a non-issue) and create lift.  If filler is injected too superficially, it can create a bluish discoloration due to light refraction called the tyndall effect.  If too much filler is injected, the eyelid can remain swollen.  Filler can last upwards of a year in this area.  Fat transfer can also be very effective.  Fat transfers tend to be more long lasting than fillers up to several years, but usually take several treatments for optimal effects.   Outcome is based upon the skill of the physician and choice of the right solution for the right problem.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 8 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.