Pros and cons of tear trough implant? Please, do not advise filler, it does not stay there.

There are still a few outliner surgeons who use these implants but it is over for these implants.  I do not recommend having them.  I think you are making a big mistake considering them.  Generally they are okay for a while but over time the implant will become visible and additional surgery will be needed to address contour exposure.  The reason why you have not had positive experience with under eye fillers is that you are having the wrong fillers placed.  This is not the location for so-called "smooth" fillers.  I call these fillers "runny."  Fillers like Belotero, Restylane Silk, Restylane Refine and Define, and the Juvederm products are low G prime, high tan delta products.  They do not hold where they are placed,  The under eye area needs high G prime, low tan delta products.  Restylane is the only product I will use in this area.  It holds up beautifully.  Don't compound past mistakes by having an outdated surgical implant placed in your undereye area.  You will be on the road to wrecking your appearance.

Tear trough implant are more invasive than filler to treat under eye hollowness and hence less commonly used, however they do have a role in select patients. Proper evaluation in consultation is needed. Another option is cheek soof lift which adds cheek fat to the tear trough area in long-term fashion.

While standard tear trough implants may be effective for some patients, it is almost always better to have custom infraorbital implants made that fit the bone better and can be designed and blended into the rim area much more naturally. This would lessen the risk of any eventual implant show with time and aging.