Tear Trough Injections vs Lower Blepharoplasties
Q: Dr. Eppley, I am interested in tear trough injections using injectable fillers. I have deep tear troughs that I think would benefit by them. I have attached some pictures for your review and recommendations.
A:Thank you for sending your pictures. Fillers or fat is not a proper procedure for your under eye concerns. What you have is overall fat protrusion of the lower eyelids with tear troughs. (medial orbital rim indentations) These are really pseudo tear troughs that are magnified by surrounding infraorbital fat protrusion. Any attempt at filling the tear troughs will likely just make your overall lower eyelids look even more puffy than they are now. The correct approach is lower blepharoplasties to remove the herniated fat and transpose it into the tear troughs with some lower eyelid skin removal/tightening.
In my opinion the only role for an injectable approach to your lower eyelids is to ‘prove’ that lower blepharoplasties are the better treatment. Given that injectable fillers in the eyelid can take a long time to resorb I would be hesitant to even try such a treatment as you would have to have puffy eyes for some time. It would be better to just proceed with lower blepharoplasty surgery.
Dr. Barry Eppley