Thank you for your question. Tear troughs or hollowing under the eyes can make you look haggard or tired. I see such conditions quite frequently.
Depending on your facial structure, they can occur in young adults or appear later in life as the bone structure around the eye weakens, causing the fat and skin to lose support. The tear trough or orbital retaining ligament at that position, which attaches from the bone to the skin, remains in place while the surrounding lower eyelid and cheek tissues move downwards and inwards. This forms a depression commonly known as a tear trough.
Tear troughs can accentuate the appearance of dark eye circles as the depression is in shadow.
What is the best treatment for tear trough hollowness?
Tear trough hollowness generally responds well to soft fillers placed into the depression. Soft filler is more suitable for the thin skin in this part of the face and generally causes less swelling compared to harder fillers. The filler elevates the area removing the shadowing, causing the hollowness to abate. I prefer to use a blunt needle (cannula) for this area to reduce the chance of bruising and increase safety. The depth of the filler placement depends on your facial structure but I generally prefer to place a sandwich of filler in both the deep and superficial planes for a more natural result.
Commonly, patients with tear troughs also have sunken cheeks and for a better overall result, I might recommend filler to the cheeks for a more balanced and harmonious look.
For severe cases, release of the tear trough ligament and interposition with filler or fat can be done. The latter is usually done surgically via lower eyelid surgery.
Rejuran is rapidly absorbed and cannot be used to correct tear trough hollowing.
Do consult a doctor who can assess your facial structure in detail and recommend an appropriate treatment plan!
Hope this helps!
Warmest regards
Dr Wan Chee Kwang
