What do I need? Tear trough? (Photo)

Question

I had tear trough filler November 2021 in December 2021. When I got them done I did not immediately notice a huge difference so I never went back and got maintenance on them. Looking at the photos from last year in 2023 I noticed that the bags under my eyes are really pronounced and noticeable. I'm just wondering if this means I just need more fillers, it's filler migration, or I need to see a surgeon for a consultation for lower eyelids surgery.

Lexie Wang, MD · Answer

It is hard to tell on these photos what is really going on. In your front photo, it does seem like maybe you have early Tyndall effect and I would consider avoiding additional filler to the area. You could benefit from a lower eyelid bleph if you wanted it.

Leonard Grossman, MD · Answer

Like the great majority of patients who have received hyaluronic acid filler in the tear trough, you show exactly the same problem where the filler has been displaced towards the nose and has created a larger bag. In your place, I would see a plastic surgeon who specializes in fat grafting. Have the hyaluronic acid dissolved with the use of hyaluronidase. And shortly after that have fed grafting performed to the same area. The results should be natural and permanent. I hope this helps in good luck from New York City Plastic Surgery.

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