Tear trough filler never works. What can I do, if anything? (Photo)

Question

Hello. I have had tear trough filler multiple times over the years, Restylane L. I have been to a facial and ocuplastic surgeon with no luck. Filler helps the cheek lid junction when my face is at rest but when I smile there is a harsh line and hollow. I have had this all my life. It slightly worsened with age but not much. Filler has been placed under the muscle. What can I do if anything? Filler doesnt stay in that that trough.

Nima Shemirani, MD · Answer

Hi @Paoletti12345! If you aren't getting enough of a correction with dermal fillers, fat grafting may have a more dramatic effect since more volume can be used. I recommend a consultation with an experienced board certified plastic surgeon. Best of luck, Dr. Nima!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. You may benefit from a combination of treatments to address the under-eye concern you’re referring to. A facial fat transfer, also known as fat grafting, can rejuvenate this area by adding volume and improving the quality of the skin.
In addition to a facial fat transfer, laser resurfacing or RF microneedling can reduce the appearance of fine lines under the eye. I recommend scheduling an in-person consultation with an experienced, board-certified injector. They will be able to discuss your aesthetic goals with you and determine the best treatment option to help you achieve them.

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

John Michael Thomassen, MD · Answer

Fat grafting may have a more dramatic effect since more volume can be used safely to address the tear trough and orbitomalar groove and blend the eyelid cheek junction.

Camille Cash, MD · Answer

You may have better luck with fat grafting if the filler isn't giving enough correction.  See an experienced board certified plastic surgeon near you for a consultation.  We also recommend using medical grade skin care products such as Transform MD and wearing sunscreen every day.

Tear trough filler never works. What can I do, if anything? (Photo)

Answers (7)

Answer: Fat Grafting

Answer: Fat Grafting

Answer: Under eye concerns

Answer: Under eye concerns

Recommended reading

Everything you need to know about Dermal Fillers

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

Tear trough filler never works. What can I do, if anything? (Photo)

Answers (7)

Answer: Fat Grafting

Answer: Fat Grafting

Answer: Under eye concerns

Answer: Under eye concerns

Browse related questions

Recommended reading

Everything you need to know about Dermal Fillers

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