Tear Trough Filler Treatments: What is the best filler for tear trough correction?

Tear Trough Filler Treatments: What is the best filler for tear trough correction?

What is the the tear trough?

The tear trough is a small indentation extending along the lower part of the lower eyelid from the corner of the eye, is influenced by genetic factors and typically worsens with age due to a loss of supporting structures under the skin, including fat, bone, muscle, and connective tissue. When we lose volume in the tear trough area you may experience a hollow appearance around the eyes.

What are my tear trough treatment options?

To address deep tear troughs, also known as eyebags, several tear trough correction treatment options exist:

1. Surgery: This permanent solution involves cutting and repositioning tissue to reduce deep creases. However, it may not have the same appearance, look more noticeable over time and could worsen aging-related changes due to tissue manipulation from your plastic surgeon.

2. Tear trough filler alone: Typically, Hyaluronic acid filler is used, but it may look less natural because treating this area alone requires significant amounts of Hyaluronic acid, often leading to puffiness and darkness under the eye area.

3. Multi-filler approach like Eyerise: This method offers a more balanced and natural cosmetic correction. It entails treating the tear trough with specialized Hyaluronic Acid fillers such as Belotero and addressing volume loss in the mid-face with a firmer filler like Radiesse, which doesn’t cause water retention. This approach treats the entire area and leverages the balancing effects of multiple dermal fillers, but it’s best performed by an experienced injector.

What is the best tear trough filler treatment? Why should I choose tear trough filler over plastic surgery?

Various fillers and products are utilized for rejuvenation in the under-eye area when treating dark circles and eye bags. It is crucial to use soft fillers (hyaluronic acid/HA) in moderation to avoid a puffy appearance. The support beneath or around the eye and mid-face should strike a natural balance between firm tissue (such as bone and connective tissue) and soft tissue (including fat and muscle) to maintain proper shape and appearance. An excess of soft tissue can lead to a bloated, puffy look.

HA fillers are commonly applied in the under-eye and mid-face areas. However, their propensity to retain water may result in puffiness, especially when applied liberally. Essentially, hyaluronic acid fillers may enhance the soft tissue aspect of the under-eye and mid-face regions.

Radiesse, a Calcium Hydroxylapatite (CaHA) filler, is composed of a substance akin to bone, adding lift and volume to the mid-face without the water retention-related puffiness. It acts as an ideal firm filler, bolstering the structural support in the mid-face area. However, this type of filler injection use is not recommended near the tear trough area close to the eye, as it can create a rough texture.

Sculptra, a Poly-L-lactic Acid filler, primarily stimulates collagen production, providing lift and support to the mid-face. Similar to Radiesse, Sculptra enhances the appearance of firm tissue in the mid-face, but it is not suitable for use near the tear trough due to the potential for a bumpy appearance.

Bellafill, a Polymethylmethacrylate (PMMA) filler, yields permanent results. However, it is irreversible and may result in uneven or over-corrected outcomes under the eye and in the mid-face area . The effects of Bellafill have the potential to increase over the years.

How long do tear trough under-eye fillers last?

Tear trough treatments with fillers typically last up to a year, though in some instances, they can persist for several years or longer. To achieve optimal results, it is generally recommended to treat both the under-eye area and the mid-face area on a yearly basis.

The main side effect people experience with under-eye fillers is puffiness from overcorrection with soft fillers.A common strategy is overloading the under-eye area and mid-face with soft Hyaluronic acid filler, which can lead to a persistent puffy and dark appearance for years

Overcorrection using an excessive amount of soft fillers (brand names include Juvederm, Restylane, Voluma, Versa, and Belotero), particularly with deep injections, may lead to long-term puffiness. A prime example is a patient I treated, who, eight years prior, had received an excessive amount of product from another practitioner.

Before consulting with me, the patient was advised to consider surgery, and at another center, laser treatments were advised. However, I was able to visualize the presence of the Hyaluronic acid filler and successfully reduced it with a series of hyaluronidase injection techniques. The patient had been suffering for 8 years with puffiness under the eyes, and the straightforward solution was to remove the fillers.

If you believe you are a good candidate for tear trough filler, schedule a consultation with Dr. Stephen Bracci.

To make your consultation, call us at (212) 888-3003 or book online by using our online booking system. 

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