Tear Trough Fillers

DS:  How do tear-trough fillers work?

DR. MAROTTA: The “tear-trough deformity” develops as people age and lose fat volume along the orbital rim. Fillers injected into the tear trough replace the lost fat volume, filling in depressions and hollows which create  a tired look and unwanted shadows.

DS:  How many injections are involved?

DR. MAROTTA: The number of injections needed varies depending upon the technique used, but generally just a few per eye is all it takes.

DS: How long does it take to see results?

DR. MAROTTA: Results are apparent immediately following injection, although some minor swelling or bruising can make the final results not apparent for a week or so.

DS: How long do the results last? 

DR. MAROTTA: Fillers in the tear trough last longer than in any other facial location.  I’ve had patients with some benefit even 2 years following injection. 

DS: Any risk for side effects?

DR. MAROTTA: Minor bruising and swelling are the most common side effects.  Contour irregularities (like lumps or bumps) are possible, but avoidable with good technique in the hands of an experienced injector. Fluctuating swelling around the filler can occur, and sometimes a blue hue or “tindle effect” in someone with very thin skin or a lot of hollowness.

DS:  Is there a brand of filler you prefer for this procedure?

DR. MAROTTA: I use either Restylane or Juvederm—both are hyaluronic acid fillers that can be somewhat molded around the eye. They can also easily be dissolved if there are any issues, or if the patient wants to have surgery in the future.

DS:  What would you say the average age of patients wanting this treatment is?  

DR. MAROTTA: Around 50, although I’ve also performed this procedure on patients in their 20s who were born with a deep tear-trough, and on patients in their 80s, who either do not want surgery or are not candidates for surgery.  

DS: Any advice for patients on the hunt for a good specialist to perform this procedure? Any potential flubs (like the dreaded droopy eye, commonly associated with Botox®) to worry about?  

DR. MAROTTA: You should seek out a board-certified physician in one of the core areas of facial plastic surgery, general plastic surgery, oculoplastic surgery or dermatology who does a lot of filler injections, especially for this very sensitive area.   Ask how many of these particular type of injections they’ve done and ask to see patient examples. The most important issue with filler injections for the tear trough is patient selection. There are certain individuals with thin skin or extreme darkness or hollows who I will not treat with filler injections. And the most common mistake I see are lumps that could have been avoided by proper patient selection and injection technique. In the case of these individuals, I will selectively dissolve the filler and correct it by re-injecting.

DS: On average, what’s the cost associated with this? 

DR. MAROTTA: The cost ranges from $600-$1200 depending on the number of syringes needed and if some volume needs to be added to the cheeks as well.  

DS: Any other advice for women hoping to attain/maintain a youthful eye contour?

DR. MAROTTA: There are many different procedures that can help to restore a youthful eyelid contour, including many different kinds of lower eyelid lifts or blepharoplasty, fat transposition, microfat transfer, midface or cheeks lift, lasers and chemical peels. Which procedure is right for you can only be determined by a thorough evaluation and physical exam by a qualified physician.  Seek out a physician who is board certified, has experience in any or all of these procedures, and look at before and after photos of patients with a similar problem to yours.  

Article posted 12/26/2012.

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