Understanding Tear Trough Deformity
As we age, our faces undergo numerous changes, and one area that is particularly affected is the under - eye region. The tear trough refers to the sunken area that forms beneath the lower eyelids, extending towards the cheeks. This area can become more prominent due to a combination of factors. Aging plays a major role; as we get older, the skin under the eyes becomes thinner, and subcutaneous fat volume is lost. This results in the tear trough area looking more sunken and the appearance of what is known as a tear trough deformity.
Some individuals are born with a congenital lack of facial fat volume in the tear trough area, leading to an under - eye hollow from a young age. Other contributing factors include loss of skin elasticity, and laxity of facial ligaments. With aging, the ligaments that hold the fat in place weaken, causing the fat that normally covers the tear trough area to descend. This creates a hollow in the position that it was once in. The skin under the eyes is thinner and more delicate compared to other parts of the face, making it particularly prone to losing volume. As the volume decreases, the skin starts to sag, resulting in a hollow or trough - like appearance.
Tear trough deformity can have a significant impact on a person's appearance, often making them look tired or older than they actually are. It is a common cosmetic concern for many individuals seeking a more youthful and refreshed look.
Treatment Options for Tear Trough Deformity
Dermal Fillers
Dermal fillers are a popular non - surgical option for treating tear trough deformity. These fillers are typically injected into the area to plump up the skin and restore volume loss. Hyaluronic acid - based fillers, such as Restylane® or Belotero, are commonly used. They are safe, effective, and provide natural - looking results. Hyaluronic acid is a substance that occurs naturally in the body and helps to hydrate and plump the skin. Different types of hyaluronic acid fillers have different characteristics, such as stiffness, flexibility, and dispersion, which can affect how they work in the tear trough area.
The benefits of using dermal fillers for tear trough treatment include reducing the appearance of dark circles, camouflaging under - eye bags and puffiness, restoring volume to the under - eye area, being non - surgical, requiring little to no downtime, providing quick results, and having a relatively long - lasting effect. The results can last for several months, typically around 6 - 12 months, although this can vary depending on the individual and the type of filler used.
Good candidates for tear trough fillers are individuals who are bothered by the appearance of under - eye hollows or dark circles and are seeking a non - surgical solution. They should have healthy skin and no underlying medical conditions that could increase the risk of complications. However, it's important to note that fillers are only useful for dark circles caused by the effect of shadowing due to loss of volume in the tear trough area. Dark under - eye circles caused by pigmentation of the skin or blood vessels beneath the skin must be treated with laser.
Fat Transfer (Autologous Fat Filling)
Fat transfer, also known as autologous fat filling or fat grafting, is another option for treating tear trough deformity. This procedure involves using the patient's own fat cells to add volume to the under - eye area. The fat is typically harvested from other parts of the patient's body, such as the abdomen, thighs, or buttocks, and then processed and injected into the tear trough.
One of the main advantages of autologous fat filling is that it uses the patient's own tissue, reducing the risk of allergic reactions or other immune - related issues. Additionally, because the fat is from the patient's own body, it can provide a more natural and long - lasting result compared to some dermal fillers. However, the procedure is more invasive than dermal filler injections and requires more time for both harvesting and injection. There is also a possibility that some of the transplanted fat cells may not survive, which means that additional treatments may be required to achieve the desired results.
Blepharoplasty
If the under - eye hollows are accompanied by under - eye bags, a lower eyelid blepharoplasty procedure may be recommended. This surgical procedure involves removing or transposing the fat causing the bags into the under - eye hollow. Blepharoplasty can also address excess skin in the eyelid area. However, it is a more invasive option compared to dermal fillers and fat transfer and has a longer recovery time. It is usually recommended for individuals with severe skin laxity, excess skin, or a large amount of fat in the under - eye area.
Types of Fillers for Tear Troughs
Hyaluronic Acid Fillers
- Restylane: A well - established brand in the field of dermal fillers. It has the right balance of stiffness, cohesivity, and a duration of effect of about a year under the eyes. It can also be fine - tailored for deep or shallow injections by modifying the filler through hydration. Restylane has different versions such as Restylane - L, Restylane Refyne, and Restylane Defyne, each with its own characteristics.
- Belotero Balance: This filler is popular for under - eyes because it is very forgiving for the injector. It is not very stiff and tends not to lump up or cause discoloration. However, it may not provide great lift if there is a deep tear trough.
- Juvederm: The Juvederm family includes several fillers suitable for the under - eye area. Juvederm Volbella XC is the first and only FDA - approved hyaluronic acid filler for the under - eye hollows and offers a refreshed appearance. Juvederm Vollure is stiffer and is a good option for deeper injections under the eyes.
Other Fillers
There are some fillers that are generally not recommended for the under - eye area, such as permanent or semi - permanent injectable fillers like BelaFill (made of plastic beads floating in pig collagen), Radiesse (calcium spheres floating in hydrogel), silicone (or Silikon 1000), and Sculptra. These fillers are not reversible, and if they are not placed in exactly the right place, lumps and bumps can be difficult to correct. There have been many cases where surgeons have had to perform surgery to remove these permanent fillers from the under - eyes.
Autologous Fat Filling of Tear Troughs
Procedure of Autologous Fat Filling
The autologous fat filling procedure for tear troughs typically begins with the harvesting of fat from the patient's body. The most common donor sites are areas with excess fat, such as the abdomen, thighs, or buttocks. The fat is harvested using a liposuction technique. This involves making small incisions in the donor area and using a cannula to suction out the fat. The harvested fat is then processed to remove any excess fluids, blood, and debris.
Once the fat is processed, it is carefully injected into the tear trough area using a fine needle or cannula. The injection is done in small amounts to ensure an even distribution of the fat and a natural - looking result. The amount of fat injected depends on the individual's needs and the severity of the tear trough deformity.
Advantages of Autologous Fat Filling
- Naturalness: Since the fat is from the patient's own body, the results can look and feel very natural. There is no risk of an allergic reaction to the filler material.
- Long - lasting: Once the transplanted fat cells have established a blood supply and survived, the results can be long - lasting compared to some dermal fillers. Some patients may only need occasional touch - ups over time.
- Multiple Benefits: In addition to filling the tear trough, the procedure can also improve the texture and quality of the skin in the under - eye area due to the presence of stem cells in the fat.
Disadvantages and Risks
- Unpredictability: Not all of the transplanted fat cells will survive. The survival rate can vary from patient to patient and depends on factors such as the technique used, the amount of fat injected, and the patient's individual healing ability. This means that additional treatments may be required to achieve the desired results.
- More Invasive: The procedure is more invasive than dermal filler injections as it involves liposuction to harvest the fat. This means a longer recovery time and a higher risk of complications compared to non - surgical options.
- Complications: There is a risk of complications such as infection, bleeding, bruising, swelling, and uneven results. In rare cases, fat embolism can occur, which is a serious complication.
Ranking of Clinics for Autologous Fat Filling of Tear Troughs in New York City
It's important to note that ranking clinics can be subjective and may vary depending on different factors such as patient reviews, surgeon experience, success rates, and cost. However, some clinics in New York City are well - known for their expertise in autologous fat filling procedures.
Neinstein Plastic Surgery
Neinstein Plastic Surgery offers tear trough filler injections, including autologous fat filling. Their approach to injection is designed to be safe and predictable. They inject the filler very deep, almost directly on the cheek bone, and slowly move the fat up towards the tear trough area. This technique is said to dramatically reduce the risk of bruising. The clinic also provides after - care support, including led light therapy devices for patients to bring home to speed up healing and incorporation of the product into the skin.
Dr. Michele Green's Practice
Dr. Michele Green is a world - renowned expert in the field of cosmetic dermatology. While she is well - known for her expertise in dermal fillers, she may also offer autologous fat filling procedures. Her practice takes a personalized approach, assessing each patient's unique needs and goals to develop a customized treatment plan. She has over 25 years of experience treating patients from around the globe for various skin concerns, including under - eye issues.
Dr. Darren M. Smith's Practice
Dr. Darren M. Smith is a board - certified plastic surgeon with an artistic eye for aesthetics. He has over 18 years of experience and is considered one of the leading specialists in enhancing and rejuvenating the delicate eye region. His practice offers tear trough filler treatments, and he may also perform autologous fat filling procedures with a focus on achieving natural, refreshed results.
Price List for Autologous Fat Filling of Tear Troughs in New York City
The cost of autologous fat filling of tear troughs in New York City can vary widely depending on several factors. These factors include the surgeon's experience, the reputation of the clinic, the amount of fat that needs to be harvested and injected, and the complexity of the procedure.
On average, the cost of autologous fat filling for tear troughs can range from $2,000 to $5,000. However, in high - end clinics or with very experienced surgeons, the cost could be even higher. It's important to have a consultation with the surgeon to get an accurate estimate based on your individual needs. Some clinics may also offer package deals or financing options to make the procedure more affordable for patients.
When considering the price, it's crucial not to compromise on quality. Choosing a board - certified and experienced surgeon is essential to ensure a safe and successful procedure. A less expensive option may carry a higher risk of complications or less satisfactory results.
Preparing for Autologous Fat Filling of Tear Troughs
Consultation
The first step in preparing for autologous fat filling of tear troughs is to schedule a consultation with a qualified surgeon. During the consultation, the surgeon will evaluate your medical history, examine your under - eye area, and discuss your goals and expectations. They will also explain the procedure in detail, including the potential risks and benefits.
You should be prepared to ask questions during the consultation, such as about the surgeon's experience with the procedure, the expected results, the recovery process, and the cost. It's also a good idea to bring any photos or examples of the look you want to achieve.
Medical Evaluation
Your surgeon may require a medical evaluation to ensure that you are a suitable candidate for the procedure. This may include blood tests, a physical examination, and an assessment of your overall health. If you have any underlying medical conditions, such as diabetes or heart disease, your surgeon will need to take these into account when planning the procedure.
Lifestyle Changes
Leading up to the procedure, you may be asked to make some lifestyle changes. This may include avoiding blood - thinning medications or supplements such as NSAIDs (non - steroidal anti - inflammatory medications), aspirin, or fish oil for a certain period before the procedure. These medications can increase the risk of bruising and bleeding. You may also be advised to avoid alcohol and caffeine in the days leading up to the appointment, as they can also increase the risk of bruising.
Recovery and Aftercare
Immediate Post - Procedure
After the autologous fat filling procedure, you can expect some swelling, bruising, and redness around the injection site and the donor area. The surgeon may apply ice packs to the treated area to help reduce swelling and discomfort. You will be given pain medications to manage any pain or tenderness. It's important to follow the surgeon's instructions regarding how to care for the treated area, such as not rubbing or massaging the area for a certain period.
Short - Term Recovery
In the first few days to a week after the procedure, the swelling and bruising should gradually subside. You may need to avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours after the procedure. You should also follow a healthy diet and get plenty of rest to aid in the healing process. The surgeon may schedule a follow - up appointment to check on your progress and ensure that the healing is going well.
Long - Term Recovery and Results
It may take a few weeks for the final results of the autologous fat filling to become apparent as the swelling completely subsides and the transplanted fat cells settle. You may notice some initial improvement in the appearance of the tear trough immediately after the procedure, but the full effect will take time. In some cases, a touch - up procedure may be recommended after a few months to achieve the optimal results.
Complementary Treatments
Autologous fat filling of tear troughs can be combined with other treatments to achieve a more comprehensive facial rejuvenation. Some of these complementary treatments include:
Botox
Botox can be used to soften the appearance of fine lines and wrinkles around the eyes, such as crow's feet. By relaxing the muscles in the area, Botox can help to give the eyes a more rested and youthful look. Combining Botox with autologous fat filling can enhance the overall rejuvenation of the eye area.
Microneedling
Microneedling uses a tool with tiny surgical - grade needles to create microscopic wounds on the surface layer of the skin. This stimulates the production of new collagen and elastin, which can help to plump and firm the skin. When combined with autologous fat filling, microneedling can improve the texture and quality of the skin in the under - eye area.
Chemical Peels
Chemical peels can revitalize the skin under the eyes by removing dead skin cells and promoting the growth of new, healthy skin cells. They can help to reduce fine lines, discoloration, and pigmentation in the eye area. A customized chemical peel can be used in conjunction with autologous fat filling to enhance the overall results.
Conclusion
Autologous fat filling of tear troughs is a viable option for individuals looking to address the appearance of under - eye hollows and dark circles in New York City. It offers the advantages of using the patient's own tissue, providing natural - looking and potentially long - lasting results. However, it is a more invasive procedure compared to dermal fillers and comes with its own set of risks and considerations.
When considering autologous fat filling, it's crucial to choose a qualified and experienced surgeon. The ranking of clinics can give you an idea of where to start, but individual research and consultations are essential. The cost of the procedure may vary, but it's important to balance price with quality to ensure a safe and successful outcome.
If you're interested in learning more about autologous fat filling of tear troughs, we encourage you to schedule a consultation with a reputable clinic in New York City. Take the time to discuss your goals, ask questions, and make an informed decision about the best treatment option for you.
