Tear Trough Filler with No Cheek Support
Tear trough formation, or hollowing under the eyes is either caused by age or genetics. It affects some as early as mid to late thirties, but is more common due to genetics affecting those at an even younger age. Hollowing under the eyes can cause one to appear older than they are or the most common complaint, always looking tired and weary.
The beginning stages of hollowing starts to look like there’s a shadow, sometimes combined with a bag that makes the tear trough look deeper. As the hollowing becomes more moderate to severe, the under-eye area appears to be darker, and the individual looks more tired. As we continue to age, we also lose volume and facial fat shifts downward in the cheek area.
Lower Eye and Cheek Rejuvenation Options
Filler, fat grafting, or surgery are great options to correct hollowing and restore facial volume that a person once had. The current anatomy of the face is important to evaluate before treatment to make sure the correct solution is done for a natural outcome. If tear troughs are corrected with filler without cheek support, the under eyes can actually look even worse than before. With no cheek support the under-eyes can appear puffier and can leave the cheeks looking flat. In a lot of cases, it is necessary to combine cheek filler and under-eye filler together to achieve the most natural looking results.
Restylane is a hyaluronic acid (naturally found in the skin) based filler which lasts approximately 6-9 months, but can sometimes last longer when placed in this area. It is a great option for this area and primarily what we use to treat tear troughs. To minimize bruising and swelling, our nurse injectors use a cannula to place the product. The product is carefully injected throughout the under the eye area until the hollows are filled in.
If cheek support is required, volume can be added with another filler recommended for cheeks like Juvederm Voluma at the same time as the tear trough filler treatment. Voluma is a thicker hyaluronic acid-based filler that is FDA-approved for use in the cheek area. Volume deficiency is typically treated a little differently than tear trough filler because the cheek is backed by the cheekbone and much thicker skin than the eyelid. This thicker filler is placed on the bone which aids in rebuilding the structure that has been lost during the aging process. Voluma also lasts much longer than Restylane, lasting up to two years.
Once the tear troughs are in the more moderate to severe stages, surgery is usually the best way to rejuvenate the under-eye area. If filler is utilized in these more severe cases, the tear troughs can begin to look even puffier than before and can lead to an “overfilled” face. Majority of fillers are never a permanent option and do need to be maintained to keep the desired results. On the other hand, lower eyelid surgery can last anywhere from years to decades.