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.

Darryl J. Blinski, MD · Answer

Based on your posted photo and descriptions I recommend nano fat grafting under local anesthesia to tear troughs. Fee $5,000. Best to virtual consult with....

Leonard Grossman, MD · Answer

There’s absolutely no better product for correcting the tear trough area than your own fat. Fat grafting when properly performed, produces natural and permanent results and can rejuvenate the face considerably by making you look a lot younger and yet natural, exactly like yourself at a much younger age. I hope this helps and good luck from New York City Plastic Surgery.

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

Answers (7)

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