Introduction
Tear trough deformity is a common cosmetic concern that can make individuals look tired or older than they actually are. Hyaluronic acid (HA) filler injection is a popular non - surgical treatment option for this issue, as it can restore lost volume and smooth out the under - eye hollows. In New York City, there are several public hospitals with highly skilled doctors who perform this procedure. This article will introduce you to the details of hyaluronic acid filling of the tear trough and share a ranking list of doctors in 3 public hospitals in New York City.
Understanding Tear Trough Deformity
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, or result from the natural loss of collagen 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 (source: https://www.michelegreenmd.com/tear - trough - fillers).
What Does Tear - Trough Filler Do?
Tear trough fillers restore lost volume in the crease below the eye and improve the appearance of dark circles and under - eye bags. Fillers, usually composed of hyaluronic acid gel, are designed to restore collagen production and replenish lost volume in the treatment area. When injected into the tear trough area, they work to reduce the appearance of dark circles and shadowing under the eyes. The preferred dermal fillers for this treatment area are composed of hyaluronic acid gel and have a small particle size. Hyaluronic acid is a component that is naturally produced by the body and helps plump the skin and increase collagen production, resulting in a more youthful - looking complexion (source: https://www.michelegreenmd.com/tear - trough - fillers).
Advantages of Hyaluronic Acid Fillers for Tear Trough
- Natural - looking Results: Hyaluronic acid fillers can provide natural - looking results, as they mimic the body's own hyaluronic acid. They can blend well with the surrounding tissues, making the under - eye area look more refreshed and youthful without an obvious “done” look.
- Non - invasive: Compared to surgical procedures like blepharoplasty, tear trough filler injections are non - invasive. There are no large incisions, and the recovery time is much shorter. Patients can usually resume their normal activities immediately after the procedure, with only minor swelling or bruising that subsides within a few days to a week (source: https://www.cangelloplasticsurgery.com/non - surgical/tear - trough - filler/).
- Customizable: Different types of hyaluronic acid fillers can be selected based on the patient's specific facial anatomy, skin concerns, and aesthetic goals. For example, Juvederm Volbella is the first FDA - approved dermal filler for treating tear troughs and contains the thinnest formulation of the Juvederm family. Restylane Eyelight is a newer dermal filler that was FDA - approved in 2023 for use under the eyes and can help restore lost volume and reduce the appearance of fine lines and wrinkles in the treatment area (source: https://www.michelegreenmd.com/tear - trough - fillers).
- Reversible: If a patient is not satisfied with the results of the filler treatment, the effects can be reversed using a product called hyaluronidase. Hyaluronidase injections contain the enzyme hyaluronidase, which can dissolve any unwanted facial filler product made of hyaluronic acid (source: https://www.michelegreenmd.com/tear - trough - fillers).
Key Considerations Before Hyaluronic Acid Filling of the Tear Trough
Patient Selection
Not everyone is a suitable candidate for tear trough filler. The best candidate is a healthy individual with noted volume loss in the under - eye area. However, if there is excessive wrinkling or skin under the eyes with fat deposition, or if the dark under - eye circles are due to skin pigmentation rather than volume loss, tear trough fillers may not be the best course of treatment. During the consultation, doctors will physically evaluate the under - eye area to determine if tear trough fillers are the correct treatment or if another cosmetic procedure is better suited (source: https://www.michelegreenmd.com/tear - trough - fillers).
Pre - treatment Preparation
Patients should avoid taking blood - thinning medications or supplements such as NSAIDs (non - steroidal anti - inflammatory medications, anything containing ibuprofen, aspirin, or fish oil) in the days leading up to the appointment, 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, as they can also increase the risk of bruising. On the day of the appointment, patients should arrive with a clean and makeup - free face (source: https://www.cangelloplasticsurgery.com/non - surgical/tear - trough - filler/).
Public Hospitals in New York City for Tear Trough Filler
New York - Presbyterian Hospital - Columbia and Cornell
This hospital is nationally ranked in 14 adult specialties and 10 pediatric specialties. It has a team of experienced doctors who are skilled in performing hyaluronic acid filling of the tear trough. Although specific doctor rankings are difficult to provide in a one - size - fits - all manner, some of the highly - regarded doctors on staff who might be involved in such procedures include those who are board - certified in dermatology or plastic surgery. These doctors take a comprehensive approach, carefully evaluating each patient's needs and formulating personalized treatment plans to achieve optimal results.
NYU Langone Orthopedic Hospital
Even though it is well - known for orthopedics, NYU Langone also has a comprehensive range of cosmetic services. The hospital is nationally ranked in 13 adult specialties and 3 pediatric specialties. The doctors here are trained to handle complex facial anatomy, which is crucial for accurate tear trough filler injections. They are likely to have access to the latest techniques and high - quality hyaluronic acid fillers to ensure the best possible outcomes for patients.
Mount Sinai Hospital
Mount Sinai Hospital is nationally ranked in 12 adult specialties and 4 pediatric specialties. The doctors in its cosmetic department are experienced in treating various facial concerns, including tear trough deformity. They are up - to - date with the latest research and developments in the field of aesthetic medicine, and can provide patients with detailed information about the procedure, potential risks, and expected results.
Top Doctors in New York City for Hyaluronic Acid Filling of the Tear Trough
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 from around the globe for a myriad of skin concerns, such as dark under - eyes, sun damage, fine lines and wrinkles, hyperpigmentation, acne, and acne scars. She is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. 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 is an expert injector who can work with patients to ensure that they are good candidates for tear trough fillers and develop a customized treatment plan that caters to their unique skin care concerns and aesthetic goals (source: https://www.michelegreenmd.com/tear - trough - fillers).
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 the patient's individual needs, goals, and medical history, and will work with the patient to develop a customized treatment plan to achieve the desired results. His patients have given positive feedback, such as feeling super comfortable during the treatment and being satisfied with the final appearance (source: https://www.cangelloplasticsurgery.com/non - surgical/tear - trough - filler/).
Dr. Adam Kolker
Dr. Adam Kolker is a double - board certified plastic surgeon. He approaches all facial aesthetic treatments by focusing on attaining the most beautiful and most effective results by using “the lowest rungs” of the treatment ladder, which maximizes beauty and safety while minimizing downtime. He will spend time understanding the patient's specific goals and desires, and then carefully assess the patient's anatomic requirements to formulate a personalized cosmetic treatment plan. He has a wide range of injectables and fillers available, including hyaluronic acid fillers, and can select the most appropriate one for the tear trough filling procedure (source: https://drkolker.com/non - surgical/injectables - fillers/fillers/).
The Procedure of Hyaluronic Acid Filling of the Tear Trough
Consultation
The first step is to consult with a doctor. The doctor will evaluate the targeted treatment area and the skin’s elasticity, confirm if the patient is a good candidate for tear trough fillers, and determine the appropriate dermal filler product and the number of syringes required to produce the best results. The doctor will also talk to the patient about their expectations and make them aware of safety issues and potential complications (source: https://www.michelegreenmd.com/tear - trough - fillers).
Anesthesia
A local anesthetic will be generously applied to the entire treatment area one hour before performing any injections to ensure that the procedure is as comfortable as possible. Additionally, the dermal fillers used for the under - eye area are often compounded with lidocaine, helping to guarantee that the procedure is as painless as possible (source: https://www.michelegreenmd.com/tear - trough - fillers).
Injection
The doctor will inject the dermal fillers directly into the skin in tiny amounts using an ultrafine needle or a cannula. Different doctors may have different preferences for the injection method. For example, some doctors prefer using a cannula for its higher level of safety, while others use an ultrafine needle for precision. The injection process is usually slow to allow the product to accommodate properly to the depression and to avoid overcorrection (source: https://www.michelegreenmd.com/tear - trough - fillers; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818415/).
Aftercare
Immediately upon completion of the procedure, ice will be applied to the treatment area to help prevent any swelling that may occur. Aftercare instructions will be provided, such as avoiding rubbing or massaging the area for at least 24 hours after the procedure, avoiding strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours after the procedure. The doctor will also schedule a follow - up appointment, usually about two weeks after the treatment, to ensure that the treatment was satisfactory and determine whether any touch - up of the hyaluronic acid dermal filler is needed (source: https://www.michelegreenmd.com/tear - trough - fillers; https://www.cangelloplasticsurgery.com/non - surgical/tear - trough - filler/).
Potential Risks and Side Effects
Common Side Effects
There are typically no major side effects associated with receiving under - eye fillers. However, it is possible to develop a mild amount of swelling or bruising at or around the injection sites. Swelling and redness are common side effects at the site of injection, and icing the treated area immediately after the injections will minimize this reaction. Bruising is another potential side effect. To decrease bruising, patients are recommended to discontinue any blood thinners as well as NSAIDs such as Advil, aspirin, ibuprofen, or Aleve, and patients prone to bruising can take Arnica Forte, an herbal supplement, to help prevent and heal bruises faster (source: https://www.michelegreenmd.com/tear - trough - fillers).
Rare but Serious Side Effects
Tyndall effect is a rare side effect that leads to the development of a bluish discoloration after some hyaluronic acid fillers are injected. The injection area can appear blue if the hyaluronic acid filler is injected too superficially. This color change can last several months in the treated area and can be reversed with hyaluronidase to dissolve the dermal filler. Some rare but more serious side effects include changes in vision, vascular occlusion, signs of infection at injection sites, allergic reaction to the dermal filler product, worsening bruising or swelling, numbness, and persistent pain. To prevent any serious or adverse side effects from developing, it is important to have the tear trough filler injections performed by an expert, board - certified injector (source: https://www.michelegreenmd.com/tear - trough - fillers).
Cost of Hyaluronic Acid Filling of the Tear Trough
The total cost of the 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, depending on the exact filler. During the consultation, the doctor will assess the patient's tear trough, cosmetic concerns, and goals to choose the best - suited dermal filler product and recommend the total number of syringes needed and the cost of treatment (source: https://www.michelegreenmd.com/tear - trough - fillers).
Conclusion
Hyaluronic acid filling of the tear trough is a popular and effective non - surgical treatment option for rejuvenating the under - eye area. In New York City, there are several public hospitals with highly skilled doctors who can perform this procedure. Doctors like Dr. Michele Green, Dr. David Cangello, and Dr. Adam Kolker are well - known for their expertise in the field. However, before undergoing the procedure, patients should carefully consider their own suitability, the potential risks and side effects, and the cost. It is also important to choose a qualified and experienced doctor to ensure the best possible results.
If you are interested in hyaluronic acid filling of the tear trough, we encourage you to schedule a consultation with a reputable doctor. Learn more about the procedure, ask questions, and make an informed decision. You can also share this article with your friends and family who may be interested in this topic, so that they can also gain a better understanding of tear trough filler treatment.
