Introduction
Tear trough depression is a common cosmetic concern that can make individuals look tired or older than they actually are. In New York City, there are numerous options for tear trough depression filling. This guide aims to provide comprehensive information about tear trough depression, the filling procedures, and the top hospitals and surgeons in the city. Whether you're considering a non - surgical or surgical solution, understanding the ins and outs of tear trough filling is crucial for making an informed decision.
What is Tear Trough Depression?
As we age, the skin under the eyes undergoes several changes. The skin becomes thinner, and subcutaneous fat volume is lost. The tear trough refers to the sunken area that forms beneath the lower eyelids, directly below the under - eye bags, and extends towards the cheeks. This can be due to a combination of factors such as aging, genetics, loss of facial fat, loss of skin elasticity, and laxity of facial ligaments.
Some individuals are born with a congenital lack of facial fat volume in the tear trough area, which causes an under - eye hollow. Tear trough deformity can create a shadow, making the under - eye area appear darker and giving the impression of tiredness or premature aging.
Treatments for Tear Trough Depression
Dermal Fillers
Dermal fillers are one of the most popular non - surgical treatments for tear trough depression. They involve injecting a hyaluronic acid - based filler (HA) into the area under the eyes to reduce the appearance of dark circles, hollows, and bags in the lower eyelid. There are several types of hyaluronic acid fillers available, such as Restylane®, Belotero, Juvederm Volbella, and Restylane Eyelight.
Benefits of Dermal Fillers:
- May reduce the appearance of dark circles
- Camouflage under - eye bags and puffiness by filling out the depression below (the tear trough) so that the lower eyelid blends more seamlessly with the cheek
- Restore volume to the under - eye area
- Non - surgical
- Require little to no downtime
- Provide quick results
- Long - lasting (typically 6 - 12 months)
Top Fillers for Tear Troughs:
| Filler Name | Features | Benefits | Considerations |
|---|---|---|---|
| Restylane | Has the right balance of stiffness, cohesivity, and relatively low swelling. Duration of effect is about a year under the eyes. Can be fine - tailored for deep or shallow injections by modifying through hydration. | Good for restoring volume and reducing hollows. Provides natural - looking results. | None significant when injected by an experienced professional. |
| Belotero Balance | Not very stiff, tends not to lump up or cause discoloration. | Forgiving for the injector. Suitable for those with mild tear trough issues. | Doesn't provide great lift if there is a deep tear trough. |
| Juvederm Volbella | Softer formulation. Causes less swelling than some other Juvederm products. | Good for shallow injections under the eyes. | There has been a low incidence of inflammatory nodules reported after 4 months. |
| Restylane Eyelight | Newer dermal filler, FDA - approved in 2023 for use under the eyes. Uses crosslinking and patented Nasha technology to erase under - eye hollowing and dark circles caused by lost volume. | Specifically designed for the under - eye area, effective in treating volume loss. | Relatively new product, long - term data may be limited. |
Fat Transfer
Fat transfer, also known as fat grafting, is a procedure where fat is harvested from another part of the body (such as the abdomen or thighs) and injected into the tear trough area. It is a more invasive option compared to dermal fillers but can provide more long - lasting results.
Benefits of Fat Transfer:
- Uses the patient's own fat, reducing the risk of allergic reactions
- Can provide a more natural - looking and long - term volume restoration
Considerations:
- More invasive procedure with a longer recovery time
- Some of the transferred fat may not survive, and multiple sessions may be required
Lower Eyelid Blepharoplasty
If the under - eye hollows are accompanied by under - eye bags, the fat causing the bags can be transposed into the under - eye hollow with a lower eyelid blepharoplasty procedure. This is a surgical option that involves making incisions in the lower eyelid to remove or reposition excess fat and skin.
Benefits of Lower Eyelid Blepharoplasty:
- Can address both under - eye bags and hollows
- Provides a more comprehensive and long - term solution
Considerations:
- It is a surgical procedure with a longer recovery time and potential for complications such as scarring, infection, and changes in vision
- Requires a skilled and experienced surgeon
Preparing for Tear Trough Filling
Consultation
Before undergoing any tear trough filling procedure, it is essential to have a consultation with a qualified plastic surgeon or dermatologist. During the consultation, the doctor will assess your tear trough area, discuss your goals and expectations, and determine the most suitable treatment option for you. They will also review your medical history, including any medications you are taking and any allergies or sensitivities you may have.
Pre - Procedure Instructions
Depending on the treatment, there may be specific pre - procedure instructions. For dermal fillers and fat transfer, you may be advised to:
- Avoid taking blood - thinning medications or supplements such as NSAIDs (non - steroidal anti - inflammatory medications, anything containing ibuprofen, aspirin, or fish oil) for a certain period before the procedure, as this can increase the risk of bruising.
- Avoid alcohol and caffeine in the days leading up to your appointment, as they can also increase the risk of bruising.
- Arrive with a clean and makeup - free face on the day of the appointment.
If you are having a lower eyelid blepharoplasty, the pre - procedure instructions will be more comprehensive and may include:
- Quitting smoking for a certain period before and after the surgery
- Arranging for someone to drive you home after the surgery and stay with you for the first 24 - 48 hours
- Stocking up on necessary supplies such as ice packs, pain medications, and moisturizers
The Procedure
Dermal Filler Procedure
This cosmetic procedure typically involves injecting the filler into the under - eye area using a small cannula or an ultrafine needle. Before the injection, a local anesthetic may be applied to the skin to minimize discomfort. The doctor will carefully inject the filler into the tear trough area, and results can typically be seen immediately. The procedure usually takes about 15 to 30 minutes, depending on the individual and the amount of filler used.
Fat Transfer Procedure
The fat transfer procedure involves several steps. First, the fat is harvested from the donor site using liposuction. The harvested fat is then processed to remove any impurities. Finally, the purified fat is injected into the tear trough area. The procedure is usually performed under local or general anesthesia, and the duration of the procedure can vary depending on the amount of fat being transferred.
Lower Eyelid Blepharoplasty Procedure
During a lower eyelid blepharoplasty, the surgeon will make incisions in the lower eyelid. If there is excess fat, it will be removed or repositioned. If there is excess skin, it will be trimmed. The incisions are then closed with sutures. The procedure is typically performed under local or general anesthesia and can take several hours.
Recovery
Dermal Filler Recovery
After getting tear trough filler, it is normal to experience some mild swelling, bruising, and redness around the injection site. These symptoms usually subside within a few days to a week and can be managed with ice packs or over - the - counter pain medications such as ibuprofen. You should avoid rubbing or massaging the area for at least 24 hours after the procedure, as this can cause the filler to shift or become dislodged. It is also recommended to avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours after the procedure. While the results of tear trough filler are immediate, it may take a few days for the full effects to be visible as any swelling or bruising subsides.
Fat Transfer Recovery
The recovery period for fat transfer is longer compared to dermal fillers. You may experience swelling, bruising, and discomfort at both the donor and recipient sites. The swelling and bruising usually peak within the first few days and gradually subside over the next few weeks. You will need to follow the doctor's instructions regarding wound care, wearing compression garments at the donor site, and avoiding strenuous activities for a few weeks.
Lower Eyelid Blepharoplasty Recovery
Recovery from lower eyelid blepharoplasty takes longer. You will experience significant swelling, bruising, and discomfort in the eyelid area. You may need to use cold compresses to reduce swelling and take prescribed pain medications. You will be advised to keep your head elevated while sleeping and avoid strenuous activities for several weeks. Sutures will be removed after a few days, and it may take several months for the final results to become apparent.
Top Plastic Surgery Hospitals and Surgeons in New York City for Tear Trough Filling
Dr. David Cangello
Dr. David Cangello is a plastic surgeon with extensive experience in tear trough filler treatments. He can recommend the best option for tear trough filler based on your individual needs, goals, and medical history and will work with you to develop a customized treatment plan to achieve your desired results. His office in New York City is a popular destination for patients seeking tear trough filler procedures.
Neinstein Plastic Surgery
Neinstein Plastic Surgery offers tear trough filler injections. Their approach involves injecting very deep (almost directly on the cheek bone starting about half - way up the nose) and slowly moving a small wave of the hyaluronic acid up towards the tear trough area. This technique is reported to be safe, predictable, and dramatically reduces the risk of bruising in the area.
Dr. Michele Green
Dr. Michele Green is a world - renowned expert in the field of cosmetic dermatology. She has over 25 years of experience treating patients for a myriad of skin concerns, including tear troughs. At her private dermatology office in Manhattan’s upper east side neighborhood, she offers a host of non - invasive cosmetic procedures for rejuvenation, including under - eye fillers. She uses an ultrafine needle for precision in tear trough injections and provides after - care instructions to ensure optimal results.
Dr. Mesa
Dr. Mesa is a board - certified plastic surgeon with a practice focused on cosmetic procedures of the face, neck, breast, and body. He has extensive training at Harvard University and other top institutions. He regularly performs tear trough correction with meticulous care to achieve results that appear refreshed, youthful, and natural.
Dr. Zuckerman
Dr. Zuckerman can help reduce dark circles with under - eye dermal filler injections. He uses Restylane - L, a hyaluronic acid filler with lidocaine, which is FDA - approved for treating the under - eye area. He injects deep into the tissues, near the bone, and can inject up to 1 cc + of filler per eye. His treatment helps patients appear rested and refreshed.
Dr. Matthew White
Dr. Matthew White has employed innovative techniques with injectables to restore fullness to the tear trough, giving patients a more youthful appearance. For more severe cases, he is able to combine these newer techniques with surgery to ensure that the tear trough treatment can produce the results in keeping with the patient’s needs.
Dr. Brett Kotlus
Dr. Brett Kotlus is a cosmetic oculoplastic surgeon. He has extensive experience and specialized training in under - eye filler treatments. He is knowledgeable about different types of fillers and can select the best filler or combination of fillers based on the patient's specific situation.
Dr. Neal Goldberg
Dr. Neal Goldberg is an extensively trained aesthetic plastic surgeon. He offers tear trough filler treatment with Restylane - L® to provide patients with effective and natural - looking results of the highest quality. His team can evaluate your tear troughs to determine the most suitable treatment option for you.
Cost of Tear Trough Filling
The cost of tear trough filling can vary depending on several factors, including the type of treatment, the type and amount of filler used, the experience of the surgeon, and the geographic location of the hospital or clinic. Dermal fillers typically cost around $1000 or more per syringe, and multiple syringes may be needed to achieve the desired results. Fat transfer and lower eyelid blepharoplasty are more expensive procedures, and the cost can range from several thousand dollars to over ten thousand dollars.
It is important to note that many hospitals and clinics offer financing options to make the procedures more affordable. Before undergoing any treatment, it is advisable to get a detailed cost estimate from the provider and understand what is included in the price.
Potential Risks and Side Effects
Dermal Fillers
While dermal filler treatment is considered safe, it does carry some potential risks and side effects, which may include but are not limited to:
- Swelling
- Bruising
- Redness
- Itching
- Infection
- Tyndall effect (a bluish discoloration that can occur if the filler is injected too superficially)
- Rare but more serious side effects include changes in vision, vascular occlusion, allergic reaction to the dermal filler product, worsening bruising or swelling, numbness, and persistent pain
Fat Transfer
The potential risks of fat transfer include:
- Swelling and bruising at the donor and recipient sites
- Infection
- Uneven fat distribution
- Fat loss over time
- Scarring at the donor site
Lower Eyelid Blepharoplasty
The risks associated with lower eyelid blepharoplasty are more significant and may include:
- Scarring
- Infection
- Changes in vision
- Dry eyes
- Ectropion (outward turning of the eyelid)
- Undercorrection or overcorrection
Conclusion
Tear trough depression filling can be an effective way to enhance your appearance and reduce the signs of tiredness and aging. Whether you choose a non - surgical option like dermal fillers or a surgical option like lower eyelid blepharoplasty, it is crucial to do your research, choose a qualified and experienced surgeon, and
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