What are Tear Trough Fillers?
Tear trough filler treatment, also referred to as under-eye filler or dermal filler, is a popular cosmetic solution for tackling tired looking eyes. It is a non-surgical procedure that involves carefully injecting a gel-like substance into specific areas around the eyes, which works to replace the lost volume brought about through the ageing process. The outcome is smoother, younger-looking, more radiant skin, and a reduction in deep wrinkles and lines.
The treatment can also be used to add volume to other areas of the face, like the lips, brows, cheeks, marionette lines and nasolabial folds, creating a more youthful appearance. Filler can also be placed throughout the face with strategic BoNT injections to create a liquid facelift or liquid eye lift, which can be highly effective in selective patients.
Why undergo tear trough treatment?
Fillers are an effective option for patients with tear trough hollows and under-eye bags. As we start to age, the area underneath the eyes, known as the tear trough area, becomes more prominent. The change in appearance often presents with dark circles and under-eye hollow, leaving a tired and exhausted look.
In addition, hollowing under the eyes can expose bags, which make the appearance worse. Filler injections help to normalise facial contouring around the lid-cheek junction and avoids the need for surgery.
If your under-eye bags are severe, a blepharoplasty procedure may be more beneficial.
At what age should you get under-eye fillers?
Tear trough fillers are an increasingly popular non-surgical aesthetic treatment amongst younger people. However, individuals of any age can undergo the procedure if they seek a fresher, more rejuvenated look, and a break from tired looking eyes by restoring volume loss.
What is the tear trough area and how does it change as we age?
The interface between our lower eyelids and upper cheek is referred to as the tear trough area. Tear trough hollowing is one of the earliest ageing changes and often is a constitutional feature present from adolescence.
As we get older, this area alters in appearance, by becoming hollower, darker, deeper, and less revitalised. These depressions can make the eyes look somewhat sunken and create unattractive dark shadows, giving the appearance of tiredness, exhaustion, and old age.
How do I prepare for tear trough treatment?
During initial consultation Dr Ezra will go through your medical history and provide a detailed examination of the eyes and face. There will be a discussion of what you wish to achieve from the treatment and the risks and benefits to allow you to reach an informed decision. If it is determined that tear trough filler is the right treatment is right for you, the filler injection will be applied.
You should avoid drinking alcohol for 24 hours before the treatment, whilst aspirin should not be taken for 7 days and Ibuprofen for two days. Again, this will be discussed with you prior to the treatment.
How is tear trough treatment carried out?
Tear trough fillers are a non-surgical, minimally invasive treatment. It involves numbing the tear trough area with a topical anaesthetic and then injecting the area with hyaluronic acid gel, which works to boost collagen production and replace the lost volume brought about through the ageing process. It also hydrates, softens, and rejuvenates the skin, creating a more youthful appearance.
The treatment only takes around 30 minutes, though many patients also opt to undergo other procedures with their fillers, such as midface lift or brow lift. You may also wish to have additional treatments such as a liquid eye lift, or a liquid facelift. Dr Ezra will discuss with you the best treatment plan during your initial consultation.
When will results be visible?
Dermal fillers produce natural-looking, instant results. While the effect is noticeable immediately, the final result will usually be visible at around two weeks. This is because the skin needs time to relax, smooth and allow the fillers to integrate properly with the surrounding tissue, achieving optimum hydration balance.
Do results look natural?
Yes, the tear trough filler treatment produces natural-looking results. Patients will not look dramatically different following the procedure. As a highly skilled practitioner, Mr Ezra understands facial anatomy and how to achieve subtle yet noticeable results.
During the initial consultation, a lot of time will be spent discussing the patient’s expectations, ensuring there is no shock results or surprise after the procedure is carried out.
Are tear trough fillers painful?
Tear trough fillers may be a little uncomfortable, but they are not painful. As this is a minimally invasive procedure, most patients find that it is a lot less daunting than they first anticipated. A topical anaesthetic numbing cream will often be applied to the area before injecting the skin, thereby reducing the discomfort.
All staff at the Daniel Ezra clinic are medically trained professionals and will ensure patients feel as comfortable as possible when undergoing facial fillers.
What happens during the under-eye filler recovery period?
Recovery is usually rapid and treatment results are normally visible right away. As there is no downtime, regular activities can resume immediately, with many patients going back to work on the same day. However, there may be some slight bruising or swelling for the first couple of days.
To reduce swelling, patients can gently apply a cold compress to the area every few hours so that heat and steam hits the face. An Arnica cream can also be generally applied to the tear trough area before bed, helping to reduce bruising overnight.
Patients should resist touching the area for at least six hours following the filler treatment. After this time, they can gently wash the area with water and soap, dabbing rather than rubbing the area. Patients should avoid using make-up or other skincare products for at least the first four hours following the treatment.
Patients should also avoid exercise and alcohol for two days and are advised to stay out of extreme heat (e.g. saunas, sun beds, tanning) or coldness for two weeks.
How long do under eye-fillers last?
While results are typically long-lasting, the treatment is not a permanent solution since the filler will gradually break down over time. Patients are advised to come back to the clinic for repeat fillers to retain their youthful, fresh appearance. Normally this will be about every 1-2 years, depending on the individual, although some patients can retain fillers for many years. You are advised to come back to the clinic for a check-up and to review your progress.
There are several different factors which can contribute to the quicker break down of the filler results, including poor diet, smoking and lack of exercise, so for optimum results, it is best to follow a healthy lifestyle.
Can Fillers be used in the upper eyelid?
Yes, hollowing in the upper lids (upper eyelid sulcus) can either occur due to natural ageing, giving a hollowed-out appearance, or as a result of surgery. Applying fillers to this area is highly specialised but can often give excellent results.
What type of filler is used?
We are often asked which filler is used. Mr Ezra uses several different fillers for different areas of the face, each specialised for a particular anatomical area. There is a wide array of different filler preparations currently available on the market and patients will be advised on which will provide the best aesthetic solution for them
Our clinic only uses filler preparations that are dissolvable, if required, and have a demonstrated safety track record. We never use any of the preparations that are associated with filler complications.
Are tear trough fillers safe?
Yes, tear trough fillers are very safe. All patients are given in-depth consultations beforehand, outlining any possible risks. Our clinic has a high level of regulation and exceeds all the recommended guidelines, making it a very safe medical environment.
Treatments will only ever be carried out by a highly skilled practitioner, as is required for the tear trough area, where the tissues are much thinner than in any other areas of the face and are much less forgiving. In addition, the proximity to the eye means that you are advised to use a skilled oculoplastic surgeon, like Daniel Ezra, for these treatments.
Are there any risks or complications?
Serious complications arising from tear trough treatment are exceedingly rare and normally the only side effect is the bruising or swelling of the skin, which is mild and subsides quickly. Undergoing any cosmetic procedure seems daunting, but tear trough fillers are very well tolerated, with a low risk profile in the vast majority of patients. However, in a small percentage of people, the filler may not be tolerated and can cause swelling or irregularities which will need further treatment.
Provided you seek treatment from only appropriately medically experienced cosmetic practitioners, you are in very safe hands. Dr Ezra will go through all potential risks with you prior to treatment.
People who are pregnant or breast feeding will not be able to undergo facial fillers. Likewise, people with known allergies or hypersensitivity to fillers or similar medical substances will be turned away.
Can other procedures be done at the same time?
A range of other extended treatments can be carried out along with under-eye fillers, including the liquid eye lift and liquid face lift. These treatments involve the placement of filler and injectables to a variety of critical locations around the eye, temple, brow, and cheek to create a softened, natural, and more youthful look. Profhilo treatment has also become a very popular adjunct to tear trough filler and can be applied at the same time.
This treatment also includes aftercare products which are highly specialised to the periocular area, enhancing skin quality. The Liquid facelift also helps rejuvenate the lower face, lifting and softening the jowl area, chin, corners of the mouth and neck.
Specialist filler correction treatment for filler complications
Mr Ezra also specialises in the management of filler complications from past procedures, carried out by other practitioners. Tear trough filler complications usually occur when the wrong type of filler has been injected into the area, or when excessive volumes have been placed in the wrong anatomical zone. Unfortunately, most practitioners are still using highly cohesive fillers which are more prone to granuloma formation and chronic swelling.
The management of skin and vision complications in this area is highly specialised and should only be performed by an expert in the field. We are also seeing a significant rise in complications caused by poorly applied filler dissolving injections, which harm native connective tissues.
The management of filler complications is varied and includes a variety of treatment options, including antibiotics, steroid injections, hyaluronidase therapy and, sometimes, surgery. If you are experiencing filler complications, they should be dealt with as a matter of urgency as they can lead to more severe and irreversible complications.
To see Mr Ezra’s article on the Aesthetics Journal on the management of complications, please click here.