Introduction

Tear trough filling has emerged as a popular cosmetic procedure in New York City. Many individuals struggle with the appearance of tired, sunken eyes caused by prominent tear troughs. This condition can be genetic or exacerbated by aging, leading to loss of volume and collagen in the under - eye area. Fortunately, tear trough fillers offer a non - surgical solution to address these concerns, providing a more youthful and refreshed appearance. In this article, we will explore some of the top plastic hospitals and clinics in New York City known for their expertise in tear trough filling, along with detailed information about the procedure, fillers used, and more.

Understanding Tear Troughs and Tear Trough Fillers

What are Tear Troughs?

A tear trough is an anatomic area of the face, specifically the hollow located between the upper cheek and the lower eyelid region. Tear troughs can cast a shadow and create the appearance of a darkened under - eye area, making one look tired or prematurely aged. They can be genetic, but they may also present due to the natural loss of collagen that occurs as we age. Reduced collagen levels in the under - eye area lead to transparent, thin skin, increasing the visibility of underlying blood vessels and creating a darkened under - eye area.

How Tear Trough Fillers Work

Tear trough fillers are a non - invasive cosmetic treatment option for rejuvenation of the under - eye area. These fillers are typically composed of hyaluronic acid, a substance that occurs naturally in the body. When injected into the tear trough area, they work to replenish lost volume, smooth out the under - eye hollows, and reduce the appearance of dark circles and shadowing under the eyes. Hyaluronic acid helps plump the skin and increase collagen production, resulting in a more youthful - looking complexion.

Benefits of Tear Trough Fillers

• Non - surgical: Unlike plastic surgery, tear trough fillers do not require incisions or a long recovery period.
• Immediate results: Patients can see an improvement in the appearance of their under - eyes right after the procedure.
• Long - lasting: The results can last anywhere from six months to a year, depending on the type of filler used.
• Natural - looking: When performed by an experienced professional, tear trough fillers provide a natural - looking rejuvenation.

Types of Fillers Used for Tear Troughs

Hyaluronic Acid Fillers

These are the most commonly used fillers for tear troughs. Some popular hyaluronic acid fillers include:

• Juvederm Volbella: It is the first FDA - approved dermal filler for treating tear troughs and contains the thinnest formulation of the Juvederm family. Its patented Vycross technology allows for a smooth and even distribution under the skin.
• Restylane: Restylane is a well - known filler for the under - eye area. It has the right balance of stiffness, cohesivity, and a duration of effect of about a year under the eyes. It also has relatively low swelling and can be fine - tailored for deep or shallow injections.
• Restylane Eyelight: A newer dermal filler that was FDA - approved in 2023 for use under the eyes. It uses crosslinking and patented NASHA technology to erase under - eye hollowing and dark circles caused by lost volume.
• Belotero Balance: It provides a soft and even correction in the skin. It has an ultra - thin and flexible formulation that can eliminate the risk of developing the Tyndall effect, a bluish hue in the injected area.

Other Fillers (Less Commonly Used)

There are also some permanent or semi - permanent injectable fillers, but they are not recommended for the under - eye area. These include Bela Fill (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 not placed correctly, they can cause lumps and bumps that are difficult to correct.

Ranking of Good Plastic Hospitals for Tear Trough Filling in New York City

1. Dr. Michele Green's Private Dermatology Office

Dr. Michele Green is a world - renowned expert in the field of cosmetic dermatology. With over 25 years of experience, she has treated patients from around the globe for various skin concerns, including dark under - eyes. At her private dermatology office in Manhattan’s upper east side neighborhood, she offers a host of non - invasive cosmetic procedures, including under - eye fillers.

Why It's a Top Choice

• Expert injector: Dr. Green is an expert injector who can assess patients' under - eye hollows and choose the right tear trough filler. She develops a customized treatment plan that caters to each patient's unique skin care concerns and aesthetic goals.
• Range of fillers: She uses a variety of hyaluronic acid fillers such as Juvederm Volbella, Restylane, Restylane Eyelight, and Belotero Balance.
• Good reputation: She is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times due to her expertise and dedication to her patients.

2. Smooth Synergy Medical Spa & Laser Center

Smooth Synergy offers a tear trough filler treatment that is highly effective for restoring a refreshed look to tired or sunken eyes. Their medical director, Dr. George Liakeas, MD, is trained and experienced in administering dermal fillers.

Benefits of Choosing This Clinic

• Simple procedure: The tear trough filler procedure at Smooth Synergy is simple and usually takes between 15 minutes to an hour, depending on the treatment area.
• Minimal discomfort: Their expert injector uses an ultrafine needle to inject the filler in tiny amounts, resulting in minimal discomfort. They may also anesthetize the treatment area with a numbing cream, and some fillers contain a numbing ingredient like lidocaine.
• Comprehensive menu: They offer a complete line of non - surgical facial treatments and a variety of cosmetic fillers, including Restylane, Juvederm, and Belotero.

3. Dr. Brett Kotlus's Practice

Dr. Brett Kotlus is a Cosmetic Oculoplastic Surgeon in NYC. He has extensive experience and specialized training in oculoplastic and cosmetic surgery.

Reasons to Consider This Practice

• Knowledgeable about fillers: He is very knowledgeable about different types of under - eye fillers and can select the best filler or combination of fillers based on a patient's individual needs.
• Avoids inappropriate fillers: He doesn't recommend using permanent or semi - permanent injectable fillers under the eyes, as they can cause problems. Instead, he prefers cross - linked hyaluronic acid (HA) gel fillers like Restylane - L.
• Can correct filler issues: He frequently corrects under - eye filler problems in NYC, making him a reliable choice if something goes wrong with a previous filler treatment.

4. Dr. David Cangello's Plastic Surgery Practice

Dr. David Cangello is a plastic surgeon with extensive experience in tear trough filler treatments. He can determine the best treatment approach that will achieve beautiful and natural results.

Advantages of His Practice

• Customized treatment: He recommends the best option for tear trough filler based on a patient's individual needs, goals, and medical history. He will work with patients to develop a customized treatment plan.
• Non - surgical benefits: Tear trough filler at his practice is a non - surgical option that offers quick results, requires little to no downtime, and can reduce the appearance of dark circles and under - eye bags.
• Patient satisfaction: His patients have reported high levels of satisfaction, with one patient saying, “He is amazing! Made me feel super comfortable as soon as I met him. He is got a lot of patience, explains every little detail and is a great listener. Not to mention his work is absolutely amazing.”

5. Dr. Zuckerman's Plastic Surgery Practice

Dr. Zuckerman can help patients reduce dark circles with under - eye dermal filler injections. He uses Restylane - L, a hyaluronic acid filler with lidocaine, for this sensitive area.

What Sets His Practice Apart

• Effective filler choice: Restylane - L is FDA - approved for treating the under - eye area and is the least hydrophilic of hyaluronic acid fillers, minimizing swelling.
• Advanced injection technique: He injects deep into the tissues, near the bone, and can inject up to 1 cc + of filler per eye, providing long - lasting results (up to 1 year) and helping patients appear rested and refreshed.
• Minimal side effects: Dr. Zuckerman is able to minimize bruising using his techniques and also by icing the affected area post - treatment.

6. Neinstein Plastic Surgery

Neinstein Plastic Surgery offers tear trough fillers as an ideal alternative to surgery for many patients. Their goal is to blend the eyelid with the cheek to give a rested and youthful appearance.

Features of This Practice

• Safe injection technique: They inject very deep (almost directly on the cheek bone starting about half - way up the nose) and slowly move a small wave of the hyaluronic acid up towards the tear trough area. This technique is safe, predictable, and dramatically reduces the risk of bruising.
• Comfortable experience: Since they numb the skin and the injections have some numbing material as well, patients should only experience some mild discomfort. They also only use cannulas (no needles under the skin), which means less trauma to the tissues.
• After - care support: They provide clear after - care instructions, including using cool compresses, avoiding rubbing the area, and not resuming strenuous activities for 24 hours. They also have led light therapy devices available for patients to bring home to speed healing.

7. Dr. Neal Goldberg's Aesthetic Practice

Dr. Neal Goldberg, an extensively trained aesthetic plastic surgeon, offers tear trough filler treatment with Restylane - L® to provide patients with effective and natural - looking results of the highest quality.

Why to Choose This Practice

• Quality filler: Restylane - L® is a clear hyaluronic acid - based dermal filler that can add volume to the tear troughs. Since it is not derived from animal products, there is no need for allergy testing before treatment.
• Comfort during treatment: A local anesthesia known as lidocaine is included in the Restylane - L® formula to help increase patient comfort during injections. An additional numbing agent can be applied to the skin beforehand if desired.
• Good results: Rejuvenation can be visible soon after injections, and patients typically report excellent results that last between six months and one year.

Procedure for Tear Trough Filling

Consultation

The first step in the tear trough filling process is a consultation with a qualified medical professional. During this consultation, the doctor will evaluate the patient's under - eye area, discuss their cosmetic goals, and determine if tear trough fillers are the right treatment option. They will also assess the patient's medical history and any medications they are taking to ensure the procedure is safe.

Pretreatment Preparation

Before the procedure, patients may be asked to avoid taking blood - thinning medications or supplements such as NSAIDs (non - steroidal anti - inflammatory medications, anything containing ibuprofen, aspirin, or fish oil) as this can increase the risk of bruising. It is also recommended to avoid alcohol and caffeine in the days leading up to the appointment. On the day of the appointment, patients should arrive with a clean and makeup - free face.

The Injection Process

One hour before the injections, a local anesthetic is usually applied to the treatment area to minimize discomfort. The doctor will then inject the chosen filler into the tear trough area using a small needle or cannula. The injection is done in small amounts to ensure precise placement and a natural - looking result.

After - care

After the procedure, ice is typically applied to the treatment area to help prevent swelling. Patients may experience some mild swelling, bruising, and redness around the injection site, which usually subsides within a few days to a week. They should avoid rubbing or massaging the area for at least 24 hours and also avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for a short period. Following the after - care instructions provided by the doctor is crucial for optimal results and to reduce the risk of complications.

Side Effects and Risks of Tear Trough Filling

Common Side Effects

• Swelling: Mild swelling is a common side effect after under - eye filler injections. It typically resolves on its own within a week, although some mild swelling may take a few weeks to resolve completely. An ice pack can be applied immediately after the procedure to mitigate swelling.
• Bruising: Bruising can occur at the injection site and usually resolves within one week. Patients can take steps to reduce the risk of bruising, such as discontinuing blood - thinning medications before the procedure and taking arnica forte, an herbal supplement.
• Redness: Redness at the injection site is also common but usually fades quickly.

Rare but Serious Side Effects

• Tyndall effect: This is a rare side effect that leads to the development of a bluish discoloration after some hyaluronic acid fillers are injected. It can occur if the filler is injected too superficially. The color change can last several months and can be reversed with hyaluronidase to dissolve the dermal filler.
• Vision changes: There is a very rare risk of changes in vision, which could be a sign of a more serious problem such as vascular occlusion. If a patient experiences any vision changes after the procedure, they should seek immediate medical attention.
• Infection: Although rare, an infection can occur at the injection site. Symptoms of infection include redness, swelling, pain, and pus. If an infection is suspected, medical treatment is required.
• Allergic reaction: While hyaluronic acid fillers are generally well - tolerated, an allergic reaction to the filler product is a rare but possible risk.

Cost of Tear Trough Filling

The total cost of tear - trough filler treatment depends on several factors, such as the medical professional performing the procedure, the geographic location of the office, the type of filler used, and the amount of filler needed. Typically, fillers cost $1000 or more per syringe. For example, at Dr. Neal Goldberg's practice, the cost of tear trough correction is approximately $950 per injection, but the final cost will depend on the individual's needs and goals. During the consultation, the doctor will be able to recommend the total number of syringes needed and provide an estimate of the treatment cost.

Conclusion

Tear trough filling is a popular and effective non - surgical cosmetic procedure for rejuvenating the under - eye area in New York City. There are many excellent plastic hospitals and clinics in the city, each with its own expertise and approach to the procedure. When considering tear trough filling, it is important to choose a qualified and experienced medical professional who can assess your individual needs, choose the right filler, and perform the procedure safely.

If you are interested in tear trough filling, we encourage you to schedule a consultation with one of the recommended practices mentioned in this article. By taking the time to research and find the right provider, you can achieve a more youthful and refreshed appearance in the under - eye area. Don't hesitate to take the first step towards enhancing your appearance and boosting your confidence. Share this article with others who may be interested in tear trough filling, and explore other related cosmetic topics to learn more about your options.