Q: Should I consider tear trough implants? I’m a licensed esthetician and I see clients on a regular basis and many do not seem to have the condition to the degree I have it at my age (I notice in older clients mostly). I noticed over the last two years due to stress and weight loss that this problem developed My lines are deep and prominent. I notice filler tends to have a better result when the skin is thicker or the tear trough is not as deep. I need to rebuild structure and form as filler only fills but still leaves a flat appearance.
Dr A’s Answer: I looked at your photos and you do appear to be a good candidate for the tear-trough implants. I very much like the results produced by the implants and do a great number of them. When sized and adjusted properly, they produce a result that can’t be distinguished from a natural tear-trough-free lower eyelid. Be sure to also have the fat pads re-draped during the procedure for the best result.
You are right to say that injectable fillers are limited. Certainly Restylane can produce improvement in a tear-trough but for more pronounced cases it just can’t achieve the goal. Soft tissue fillers in general are hampered by their mobility and risk of bulging during smiling when used in larger quantities. The implant can be thought of as an adjustment to the shape of the bone, not the soft tissue so it does not bulge with facial expression.