Wondering what is the defect with my nasojugal area and if a lower blepharoplasty is right for me? (photos)

Question

I’m very lean and have always had genetically deep tear troughs but feel like I’m too young to have this sort of deformity on my face. Feels too assymetrical and “ligament looking” towards nose to be a true tear trough issue. I have had HA cheek and under eye filler before. I had a consult for a lower blepharoplasty but I’m not quite convinced that’s the solution?

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! The area you're referring to can be very challenging to improve. A lower blepharoplasty addresses the area above the nasojugal region so I don't see how that would help significantly. Fat transfer may be a great option. This involves harvesting from around the belly button and using the fat as natural filler. Larger volumes can be finessed and the results last 5-10 years on average. If you haven't tried Morpheus8, that may help to tone the skin in the region with minimal downtime. There are firming creams as well for under the eyes which do work. Hope this helps you!

Marc Polacco, MD · Answer

Thank you for your question. The tear trough region is usually where people start to show aging first. In this region, tissue can descend, and we also lose volume. Typically adding volume is easier, and this can be accomplished via filler or fat transfer. Surgical options could entail a lower blepharoplasty with fat transposition (if you have prominent lower eyelids due to fat pads) or a SOOF lift (similar to a lower blepharoplasty, but some of the lower eyelid/cheek fat is brought upward). I hope this helps give you a rough of idea of options, and I wish you all the best.
-Dr. P

Ajaya Kashyap, MD · Answer

Thank-you for your query. The hollow areas that you have mentioned are best filled with a filler or autologous fat. A lot of care has to be taken while using any kind of filler in the area because of the blood vessels present here . A very thin hyaluronic  filler works well as does a “nano fat” injection technique. Blepharoplasty can certainly be done when you are older and more comfortable with the surgical option. All the best!

Zoran Potparic, MD · Answer

It is impossible to give you good advise based on these photos; close up photos, in person or telemedicine consult would help. People with relatively small cheek bones, have a tendency to develop tear though deformity and tired look as early as early twonties or even earlier. Doing transconjuctival lower blepharoplasty with or without addition of fat grafts, can significantly improve that problem. Good luck.

Kenneth R. Francis, MD, FACS · Answer

Dear Alcova1216,

We don't know your age and the photos are from quite a distance.  We are also at a disadvantage without physically examining you.  However, you appear young for a blepharoplasty, and very attractive.  A blepharoplasty would likely provide some improvement, especially if some fat grafting (in whatever manner) is done.  Of course, surgery always carries risk.  Continued fillers, or fat transfer by injection are options as well.  Good luck!

Wondering what is the defect with my nasojugal area and if a lower blepharoplasty is right for me? (photos)

Answers (6)

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

Answer: Tear trough correction

Answer: Tear trough correction

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Wondering what is the defect with my nasojugal area and if a lower blepharoplasty is right for me? (photos)

Answers (6)

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

Answer: Tear trough correction

Answer: Tear trough correction

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.