How long after a lower bleph should one wait before having filler under the eyes and tear trough?

Question

I had an upper and lower bleth. it has been 17 weeks. My lower eyes are very hollowed now and mt tear troth on one eye is more pronounced. I was told by removing the fat pad that would fix that, but it made it worse. My surgeon who does not do any filler thinks I should wait until I am completely healed. I am going to Canada and heard I could get Restalyn Silk. But I will be there the 10th--18th of this month. So that puts me at 18-19 weeks after surgery. thoughts?

Rod J. Rohrich, MD · Answer

I would question the need for filler after a
properly done Blepharoplasty. Certainly I would
wait 6 months to a year before considering having fillers done. I would then consider using
a hyaluronic acid filler like Restylane for the tear trough correction, which will not cause
significant swelling and can last for over a year.

Jason Emer, MD · Answer

Most people suggest waiting 3 months, but to be honest, if the procedure was through the eyelid, there is no reason you cant have filler a few weeks after the procedure -- unless the fat pads were contoured/sutured.  I suggest seeing a dermatologist with expertise in fillers and lasers.  I find that sublative rejuvenation and/or nonablative lasers after bleph substantially help with tightening and textural improvements.  I would avoid botox for a while though (under the eye).  Best, Dr. Emer.

Jonathan Kulbersh, MD · Answer

It would be safe to have tear trough filler after a blepharoplasty.  If you have a depression in the area at 17 weeks after surgery, I believe you could have filler in tear trough at this time. I would not travel to have this area.  I would have the filler injected by a local injector with a great reputation.  In this manner, you will be able to have a doctor follow up with you after the injection to ensure the best results. I hope this helps.

John J. Martin, Jr., MD · Answer

It is best to wait until most of the inflammation has subsided before doing fillers but at 4-5 months post-op you should be doing pretty well and can do the fillers.  Restylane silk is a very thin filler, so will work well in the tear trough but may not last as long as regular restylane.  There are many good injectors in Tuscon so I would recommend having it done close to home.

David S. Motoki, MD · Answer

I would follow the recommendations of your surgeon as to when you can get fillers. He/ she is in the best position to determine when you have healed and it is time to do fillers even if he/ she does not do fillers.

Chad Robbins, MD · Answer

Waiting atleast 3 months after lower eyelid blepharoplasty should be fine to have juvederm or restylane injected in your troughs.  I would ask your Surgeon if he knows of credible injectors in your area and sta away from having it done in another country.  If you need to add more or tweak what they did, you would want to go back to the same injector.

Katrinka L. Heher, MD · Answer

I recommend waiting 12 weeks as all of the swelling is usually resolved by then. That being said restylane remains the safest filler for the tear troughs. I also would stay local for this treatment as you want to get it perfect as it will last for many years. Its very important to avoid overfilling this area, thus it is helpful to have the option of tweaking the treatment a few weeks later. Good luck.

John R. Burroughs, MD · Answer

Without pictures it is difficult to provide the best suggestion unique for your situation, but most swelling is gone by 3 months.  Therefore, at 18-19 weeks after surgery, I would think you should be stable.  Be sure to have an experienced injector.  Best regards.

Michael Law, MD · Answer

I'm so sorry you are experiencing this. Sadly, people often report aggressive removal of fat during blepharoplasty surgery. I correct this often by means of fat grafting.  If you view by before and after gallery, I have dozens of examples of fat grafting under the the eye, the upper yelid / brow junction and in the tear trough areas. I would not us ANY OTHER material in that area.Structural fat grafting can be performed for filling sunken hollows under eyes , to fill sunken cheeks, to correct hollowed eyelids, and is often used for blepharoplasty correction when too much skin and or fat has been removed in an eyelid surgical procedure.Structural fat grafting is a procedure in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.Fat Grafting requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements are possible.It is important to view photos a few weeks after the procedure is performed and then six months or more agter the procedure has been performed.With other fillers, like Restylane, I see results that are inconsitent at best. Never have I seen even a dozen before and after images of resylane around the eye in a gallery.  Fat grafting requires experienced, specialized training and patience. Yoiu mist seek a physician with an excellent record of lobgevity and providing natural looking results with fat grafting.

How long after a lower bleph should one wait before having filler under the eyes and tear trough?

Answers (9)

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