Filling in Hollow Lower Eyes (Tear Trough Deformity)
As we age we lose volume to the face and one of the first places that this becomes noticeable is the lower eyes. This problem has been termed the Tear Trough Deformity. There are many methods to correct this problem and the appropriate method really depends on the patients given anatomy and goals. Filling of the tear trough can be very effective and noninvasive. I perform this procedure with Restylane or Juvederm or fat. The fillers are done in the office with local anesthesia and take about 10 minutes to do. There is no functional downtime and the person can go right to the gym but there may be a small amount of bruising or swelling that can last a few hours to a few days. The fillers last about 6 months. Fat injection to the tear trough is the most common method that I use to correct the tear trough because fat does the best job at filling the hollowness. This does require liposuction to harvest the fat so this procedure is done in the operating room. There usually is bruising or swelling for about 7-10 days with this procedure but the person can be back at work the next day if need be. Fat injections can be permanent although that is not guaranteed because the longevity is variable and unpredictable as everyone is different. There are 2 guaranteed permanent methods of filling the tear trough including lower blepharoplasty with fat repositioning and tear trough implants. The lower blepharoplasty is a very specialized and advanced type of blepharoplasty that corrects both the bags and the hollowness. The implants are made of a solid silicone and are placed from inside the lower eyelid. I perform all of these procedures very often and they are all excellent ways to refresh and rejuvenate the face. The appropriate technique will depend on one’s anatomy and goals and after talking to and examining a person I will be able to determine which technique is best for that person.