Tear trough rejuvenation is a non-surgical cosmetic procedure for people who have dark circles or hollows in their lower eyelids, also known as “tear troughs” or “tear trough abnormalities”. Tear trough fillers are most likely to go wrong when administered by inexperienced practitioners that lack a sufficient grasp of patient anatomy, may use the incorrect type of filler, or do not properly choose patients eligible for this type of therapy.
Why Do We Get Tear Troughs?
Our face structure changes as we age. Our skin thins and crepes, and we see increased pigmentation and hollowing under the eyes. It also doesn’t help that we lose fat, bone, and volume around our eyes and cheeks and that the fat pads around our eyes might shift, creating bulges, sometimes known as eye bags. This, along with the hollowing caused by bone and tissue loss, can result in deep depressions known as tear troughs (between the cheek and the eyelid) that make us appear sleepy even when we aren’t. The fat pads in the face provide volume and support, and when support is lost, the tear trough may become more pronounced. Fortunately, there are treatments available to help address this problem, and one of the most popular is under-eye fillers, also known as tear trough fillers.
Tear troughs are a difficult region to treat and should be tried only by skilled injectors. Dermal filler in the tear trough, when used appropriately, can lessen the appearance of weariness under the eyes and alleviate the sunken impression that occurs as we age. The difficulties might arise as a consequence of improper filler selection, in case of a lack of understanding of the patient’s anatomy, or poor patient selection. That’s why tear trough treatment should only be performed by trained professionals.
Safe Tear Trough Treatment:
This technique has grown in popularity in recent years, as patients seek a quick, painless solution to the problem of tear trough hollows and under-eye bags, which are a natural outcome of the aging process, in which the skin loses volume and becomes droopy. Tear trough therapy, when done correctly, can result in a smoother, younger, more revitalized appearance, as well as a visible reduction in under-eye bags and deep wrinkles. Treatments typically last 30 to 60 minutes. The initial step in your therapy will be to deliver an anesthetic to make you feel more at ease. If it hurts, you should notify your practitioner since it should be “uncomfortable” or feel weird, but not painful.
It’s critical to visit a medically certified practitioner for under-eye fillers because if they’re injected into the wrong place (or you have a bad response to the solution), you need to be in the hands of someone who understands what to do. All it takes is for a needle to pierce a blood vessel to cause problems. There are two major approaches to treating tear troughs and under-eye bags.
1. Treating Cheek Volume:
The trough might appear as a result of volume loss in the cheek fat pads. If this is the case, treating the upper cheek with dermal filler can typically offer adequate support to the under-eye region while also reducing the appearance of the tear trough.
2. Tear Trough Dermal Filler:
If you have decent cheek volume but a deep tear trough, dermal filler can be injected into the tear trough to elevate the region and minimize the depth of the line. The disadvantage of this procedure is that it has a slightly increased chance of bruising. Depending on the type of filler used, a tear-trough filler can last up to 9 months. The under-eye region is fragile; thus, the practitioner should be cautious with the quantity of filler they may apply. One of the most challenging locations to treat is the area around the eyes. Because this is a region prone to water retention and puffiness, it is important to be cautious not to use too much dermal filler in this area. Bruising around the eyes is very likely.
Tear Trough Problems:
The tear trough is a difficult place to treat since the tissues are thinner than in other parts of the face, making any problem much more visible. Similarly, because of its proximity to the eye, tear trough therapy is best conducted by competent oculoplastic surgeons, who know the complicated anatomy of the eye area and can successfully handle any post-operative eye-related issues that may emerge.
Overfilling the tear trough can cause lumps, which are commonly visible when smiling or gazing at the tear trough from above. Many injectors frequently meet patients who have had filler injected incorrectly in the tear trough, often with a cannula, resulting in a sausage-shaped mass under the eye. To treat it, the filler is dissolved before the restart. As difficult as it may appear, overfilled tear troughs do not look attractive, and it is advisable to dissolve the filler and rebuild the region with less substance.
2. The Tyndall Effect:
The ‘Tyndall’ effect occurs when a filler is injected too superficially beneath the skin. When treating the tear trough, the filler should be injected deep into the skin. It might cause a blue or green discoloration that is most visible in daylight, if the filler is applied too superficially. Filler that has been applied too superficially should also be dissolved. To break down the filler, an enzyme can be utilized. Clients are asked to return in a week so that the filler is re-injected in the proper location.
After tear trough filler, some patients may have swelling in the mid-cheek or beneath the eye. The issue here is that the filler was put either above the orbicularis retaining ligament or too superficially beneath the skin. Dermal filler collects water, which can produce sporadic swelling beneath the eye if applied too near to the skin. Again, dissolving the filler is the solution. After the dermal filler has been dissolved, clients are examined for 1 week to see if they are a good candidate for filler under the eyes. To decrease swelling, the dermal filler should be inserted deep into the skin, beneath the retaining ligament. Caution must be exercised when selecting a dermal filler product since they differ in terms of how much water they draw and how much they have the ability to swell.
Patients Not Suitable for Undereye Filler:
1. Excess Undereye Skin:
Patients with loose skin around the eyes may be a better candidate for surgery than dermal filler, and it can be determined once the dermal filler has been dissolved. People with significant under-eye bags or loose skin may be better suited for blepharoplasty, a long-term remedy to tired-looking eyes. The removal of extra skin and muscle from the upper or lower eyelid area, as well as the reduction or repositioning of underlying fat, results in a more youthful look.
2. Dark Circles Under Eyes:
Dark circles beneath the eyes are difficult to cure, and dermal filler treatments will not eradicate the pigmentation. Patients with darker skin types are more likely to have black circles. Excessive rubbing, hay fever, or eczema patients can develop dark circles beneath the eyes. To diminish the appearance of dark circles beneath the eyes, laser or chemical peels can be used, but this should only be done by an experienced specialist. In individuals with dark circles, dermal filler can be utilized beneath the eyes, as inserting filler in the tear trough can modify the way light bounces off the skin and lessen the appearance of darkness.
3. Malar Bags:
Festoons, also known as malar bags, are bloated, puffy bags that form beneath the eyes and are often caused by midface aging. The development of malar bags as a result of an earlier tear trough filler therapy is a fairly prevalent condition. Because fillers promote swelling, any patient who has malar bags or festoons should avoid filler therapy, as it would only aggravate the condition.
Am I A Suitable Candidate?
This is an excellent therapy for many people who suffer from profound depressions in the under-eye region. However, it’s critical to schedule a consultation with a medically certified practitioner before your visit since the under-eye region is complicated, and it’s critical to know what’s causing dark circles or puffiness before treating it.
Individuals who are pregnant, nursing, or attempting to conceive, as well as those who are allergic to lidocaine, should avoid using under-eye filler. It’s also not a good idea to inject in this location if it’s contaminated, so consult with your practitioner to establish the best course of action in this scenario. You should also avoid this therapy if you are prone to blood clots or have keloid scarring. Inform your practitioner about any ailments, vitamins, or medications you are taking so that they can assess whether the fillers will have an effect on this.