Simple secret – Tear trough filler – Why only an experienced doctor should do it for you
Patients consult me about 3 things that concern them about the lower eyelid:
- Eye bags – the only effective way to treat this is with a surgical procedure called a lower lid blepharoplasty (What to expect from eyelid surgery – Dr Jonathan Toogood (doctortoogood.co.za))
- Tear troughs with or without dark pigment or discoloration.
- A combination of the above
Tear troughs or under eye hollows are well defined, dark and deep hollows that are located between the lower eyelid, nose and upper cheek.
After a thorough consultation, I can determine if the tear trough is caused by a tight orbital retaining ligament or lack of volume between the bone of the orbital rim and the skin. If it is the latter, then some sort of “filler” can be considered.
As a Plastic surgeon, my first choice is the use of fat injections or fat grafting. Because the fat cells transferred into the area are living cells that will cause a “permanent” * improvement in the area. The colour of the fat cells also helps to counteract the dark pigment and discolouration in this area.
If the situation is mild and/or surgery is not an option for the patient or if the patient wants a “quick fix” and doesn’t mind returning for “touch-ups”; then a collagen filler (consisting of hyaluronic acid – HA)) can be used. There are many types of HA filler – each with their own formulations and thicknesses. The undereye area requires a very soft, mouldable or “flowing” filler to add volume to the area without creating lumps. Very dense filler injected too close to the surface of the skin can cause a visible blue shine through the thin lower eyelid skin.
For both techniques used to eliminate tear troughs, a second procedure following shortly after the first is highly likely to be necessary to smooth out any irregularities once the fat or filler has settled.
There are some dangers to injecting fat or filler in this area:
The blood vessel anatomy in the area needs to be considered. If a practitioner accidentally injects a bolus of filler into one of the vessels, there is a high risk of the product blocking the blood vessel causing blindness. One or two cases of this are reported worldwide per year. The way to prevent this happening is to use a blunt tipped injection needle.
Because of this it is essential that the person injecting filler around your eyes should be an expert who does it frequently.
All considered it is a very safe and very effective treatment which has a short down time, minimal pain and an almost immediate result.
*In this case the word “permanent” means the treatment is a “once off treatment” which does not be repeated every few months to maintain the result. The face continues to age and the word “permanent” used in this context is not meant to give the impression that the eyes will remain youthful for the rest of your life.
