Tear Trough Implants

Q: Dr. Eppley, Do you offer tear trough implant via transconjunctival approach? If so do you still use a screw to anchor the implant? I had both lower eye lid blepharoplasty via transconjunctival approach in 2010. Now I have a moderate amount of tear trough deformity. I am considering implant not filler. Is this procedure done under Local/Mac or General Anesthesia? How often is this procedure done in your office? Thank you very much.

A: Tear trough implants can be placed through a transconjunctival lower blepharoplasty approach. In most cases they can be secured with microscrews through this approach. This is a procedure that is done under general anesthesia. I have dine many tear trough implants and my new designs for these implants make it possible to more easily place them through either a transconjunctival approach or an intraoral approach which I prefer. The original and still used designs of tear trough implants were developed long ago before the use of injectable fillers made awareness of the tear trough deformity what it is today. The best design for a tear trough implant is one that wraps around the medial orbital rim as well as goes over the anterior surface of the orbital rim down onto the upper maxilla.