Introduction
As we age, the area under the eyes can undergo significant changes, often leading to the appearance of tear troughs. These depressions can make a person look tired, older, and less vibrant. Hyaluronic acid filling in the tear troughs has emerged as a popular non - surgical solution to address this concern. In New York City, there are several well - established hospitals and clinics that excel in this procedure. In this article, we will provide a detailed summary of three such places: Neinstein Plastic Surgery, Cangello Plastic Surgery, and Dr. Michele Green's clinic.
Understanding Tear Troughs and Hyaluronic Acid Filling
What are Tear Troughs?
The tear trough is the natural depression that runs from the inner corner of the eye towards the cheek. It can become more prominent due to factors such as aging, genetics, loss of facial fat, and reduced skin elasticity. As we age, the skin under the eyes becomes thinner, and the fat pads that once provided support and fullness may shift or atrophy, leading to the deepening of the tear trough. This can create a shadow under the eyes, giving the appearance of dark circles and a tired look. Some individuals may also be born with a more pronounced tear trough due to genetic factors.
How Hyaluronic Acid Filling Works
Hyaluronic acid is a substance that occurs naturally in the body. It has the unique ability to attract and hold water, which makes it an ideal filler material for restoring volume and plumpness to the skin. When injected into the tear trough area, hyaluronic acid fillers work by filling in the depression, smoothing out the transition between the lower eyelid and the cheek, and reducing the appearance of dark circles and hollows. The filler helps to restore the lost volume, giving the under - eye area a more youthful and refreshed look. Different types of hyaluronic acid fillers may be used, each with its own properties and characteristics, depending on the patient's specific needs and the injector's preference.
Neinstein Plastic Surgery
Overview
Neinstein Plastic Surgery is a well - known practice in New York City that offers tear trough filler injections. They have a team of experienced professionals who are dedicated to providing high - quality cosmetic treatments. Their approach to tear trough fillers focuses on safety, predictability, and achieving natural - looking results.
Candidate Selection
Neinstein Plastic Surgery notes that tear trough fillers are not suitable for all patients. They do not recommend the procedure for patients with very thin skin that appears to be almost attached to the cheekbone, as the filler may be visible. Additionally, pregnant or breastfeeding patients are deferred for safety reasons. Good candidates are those who have noticeable volume loss in the tear trough area and are looking for a non - surgical solution to improve their appearance. These patients should have realistic expectations about the results and understand that the procedure can enhance their look but may not completely eliminate all signs of aging or fatigue.
Procedure Preparation
Prior to the appointment, patients are advised not to use blood thinners like aspirin for 5 days before the procedure. This is to reduce the risk of excessive bruising. On the day of the injections, makeup is removed, and the skin is numbed for 20 minutes to ensure patient comfort during the procedure.
Injection Process
At Neinstein Plastic Surgery, the injection technique involves injecting the hyaluronic acid very deep, almost directly on the cheekbone starting about half - way up the nose, and then slowly moving a small wave of the filler up towards the tear trough area. This approach has been found to be safe and predictable, and it significantly reduces the risk of bruising in the area. The practice only uses cannulas (no needles under the skin), which causes less trauma to the tissues. After the injections are complete, ice is placed on the eyes for 5 minutes, and the patient takes a one - time dose of steroids to reduce swelling.
Recovery and Aftercare
Immediately following the treatment, patients are advised not to rub or massage the treated area. When cleansing the face or applying makeup, gentle, sweeping motions should be used to avoid excessive movement of the filler. Patients should wait 24 hours before resuming strenuous activities that can raise their heart rate and blood pressure, such as exercise and sex. Bruising at the treatment site may occur, and temporary, minimal to moderate swelling is also expected. Cool compresses can be applied to the treated area (avoiding pressure) to reduce swelling. Mild tenderness at the treatment site may last for a few hours or, at times, a couple of days, and patients can take acetaminophen/Tylenol if they experience any discomfort. It is recommended to wait a minimum of four weeks before receiving any laser treatments. The clinic also has led light therapy devices available for patients to take home to speed up the healing process and the incorporation of the filler into the skin.
Cost and Results
The goal at Neinstein Plastic Surgery is to price their tear trough filler injections in a way that makes the procedure accessible to patients who are eager to enhance their look. The volume change is immediate after receiving the fillers, but full tissue integration and settling take about a week. Patients can check the clinic's injections pricing page for specific cost details.
Cangello Plastic Surgery
Overview
Cangello Plastic Surgery, under the expertise of Dr. David Cangello, is another prominent option in New York City for tear trough filler treatments. Dr. Cangello has extensive experience in performing this procedure and is committed to providing customized treatment plans to achieve beautiful and natural results.
Understanding Tear Trough Deformity
Dr. Cangello explains that tear trough deformity can occur due to a combination of factors. As we age, the skin under the eyes becomes thinner, subcutaneous fat volume is lost, and the facial ligaments become lax. This can cause the fat that normally covers the tear trough area to descend, creating a hollow. Some individuals may also be born with a congenital lack of facial fat volume in the tear trough area, resulting in an under - eye hollow. This deformity can make a person look tired or older than their actual age.
Benefits of Tear Trough Filler
Tear trough filler offers several benefits. It can reduce the appearance of dark circles, camouflage under - eye bags and puffiness by filling out the depression below the eyes, and restore volume to the under - eye area. The procedure is non - surgical, requires little to no downtime, provides quick results, and can be long - lasting. It is an effective and convenient option for those looking to improve the appearance of the under - eye area without undergoing surgery.
Candidate Selection
Good candidates for tear trough filler at Cangello Plastic Surgery are typically 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. It is important for candidates to have realistic expectations about the results and understand that the treatment can provide improvement but not perfection. Tear trough filler is mainly useful for dark circles caused by the shadowing effect of volume loss in the tear trough area. Dark under - eye circles caused by skin pigmentation or blood vessels beneath the skin need to be treated with laser. Those with severe skin laxity, excess skin, or fat in the under - eye area may be better suited for surgical options like eyelid surgery (blepharoplasty).
Procedure Preparation
Before the procedure, patients should discuss their medical history, medications, allergies, and sensitivities with Dr. Cangello. In the days leading up to the appointment, they should avoid taking blood - thinning medications or supplements such as NSAIDs (e.g., ibuprofen, aspirin, or fish oil), as these can increase the risk of bruising. It is also recommended to avoid alcohol and caffeine during this time. On the day of the appointment, patients should arrive with a clean and makeup - free face.
Tear Trough Filler Procedure
The tear trough filler procedure at Cangello Plastic Surgery involves injecting the filler into the under - eye area using a small cannula. Results can typically be seen immediately. The effects of the filler can last for several months, although this can vary depending on the individual and the type of filler used. The procedure usually takes about 15 to 30 minutes, depending on the individual and the amount of filler needed.
Recovery and Aftercare
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. Patients should avoid rubbing or massaging the area for at least 24 hours after the procedure to prevent the filler from shifting or becoming 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 are immediate, it may take a few days for the full effects to be visible as any swelling or bruising subsides. Following the aftercare instructions provided by Dr. Cangello is crucial to ensure optimal results and reduce the risk of complications.
FAQs
- What are dermal fillers? Dermal fillers are injectable cosmetic treatments used for facial enhancement, such as adding volume, smoothing wrinkles, and contouring facial features. They can be made from various materials, including hyaluronic acid fillers, which can be dissolved with hyaluronidase.
- Is the tear trough filler procedure painful? The level of discomfort can vary depending on the patient's pain tolerance and the injector's technique. Since the skin is prepped with a numbing agent, most people describe the procedure as relatively comfortable with only minor discomfort. Dr. Cangello uses a cannula for injection, which further reduces pain.
- How long do the results of tear trough filler last? The results typically last for around 6 - 12 months, but this can vary depending on the individual, the type of filler used, and other factors such as lifestyle, genetics, and age.
- Does tear trough filler have any side effects? While the treatment is considered safe, it can have some potential risks and side effects, including swelling, bruising, redness, itching, and infection. These side effects are usually mild and temporary and can be managed with ice packs or over - the - counter pain medications.
- What is the cost of tear trough filler? The cost can vary depending on factors such as the type and amount of filler used. Multiple syringes may be needed to achieve the desired results, and the number of syringes required depends on the patient's specific needs and goals.
- Can I combine other treatments with tear trough filler? Yes, many patients choose to combine tear trough filler with other injectables such as Botox for more comprehensive non - surgical facial rejuvenation.
Dr. Michele Green's Clinic
Overview
Dr. Michele Green is a world - renowned expert in cosmetic dermatology. Her private dermatology office in Manhattan's upper east side neighborhood offers a range of non - invasive cosmetic procedures, including tear trough fillers. With over 25 years of experience, she is known for her expertise in treating patients from around the globe for various skin concerns.
Types of Fillers Used
Dr. Green often uses hyaluronic acid fillers such as Juvederm Volbella, Restylane, Restylane Eye Light, and Belotero Balance for tear trough treatments. Hyaluronic acid is a natural substance in the body that helps plump the skin and increase collagen production.
- Juvederm Volbella: It is the first FDA - approved dermal filler for treating tear troughs and has the thinnest formulation in the Juvederm family. Its patented Vycross technology allows for a smooth and even distribution under the skin.
- Restylane Eye Light: This newer dermal filler 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. Its ultra - thin and flexible formulation eliminates the risk of the Tyndall effect, which can cause a bluish hue in the injected area.
Candidate Selection
The best candidates for tear trough filler at Dr. Green's clinic are healthy individuals with noted volume loss in the under - eye area. However, if there is excessive wrinkling or skin under the eyes with fat deposition, tear trough fillers may not be the best option. During the consultation, Dr. Green physically evaluates the under - eye area to determine if tear trough fillers are the correct treatment or if another cosmetic procedure is more suitable. If a patient is not a suitable candidate for non - invasive options, she will refer them to a trusted board - certified plastic surgeon for a surgical consultation.
Procedure
The first step is a consultation with Dr. Green. She evaluates the targeted treatment area and the skin's elasticity, confirms the patient is a good candidate, and determines the appropriate dermal filler product and the number of syringes required. A local anesthetic is applied to the entire treatment area one hour before the injections to ensure patient comfort. The dermal fillers used by Dr. Green are compounded with lidocaine to further minimize pain. She uses an ultrafine needle to inject the dermal fillers directly into the skin in tiny amounts. After the procedure, ice is applied to the treatment area to prevent swelling, and aftercare instructions are provided. Dr. Green also schedules a two - week follow - up to ensure treatment satisfaction and determine if any touch - up of the hyaluronic acid dermal filler is needed.
Side Effects and Safety
There are typically no major side effects associated with tear trough fillers. However, mild swelling, bruising, or redness at or around the injection sites are possible. Icing the treated area immediately after the injections can minimize these reactions. Bruising can be reduced by discontinuing blood thinners and NSAIDs before the procedure. Patients prone to bruising can take Arnica Forte, an herbal supplement, to help prevent and heal bruises faster. The Tyndall effect, a rare side effect that causes a bluish discoloration, can occur if the filler is injected too superficially. It can be reversed with hyaluronidase. 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 these, it is crucial to have the injections performed by an expert like Dr. Green.
Effectiveness and Duration
Under - eye fillers are ineffective for treating naturally darker skin pigmentation in the under - eye area. If the dark circles are due to skin pigmentation, treating with dermal fillers may emphasize their appearance. In such cases, Dr. Green recommends the Mesopeel Periocular®, a specially formulated chemical peel. Dermal fillers typically last for six to twelve months, depending on the filler used and the patient's metabolism. Eye rejuvenation with tear trough filler treatment can be repeated on an annual or biannual basis to maintain the desired cosmetic results.
Cost and Complementary Treatments
The total cost of tear - trough filler treatment depends on factors such as the medical professional, location, type of filler, and amount of filler needed. Typically, fillers cost $1000 or more per syringe. Dr. Green can assess the patient's tear trough, cosmetic concerns, and goals during the consultation and recommend the appropriate dermal filler and the total number of syringes needed, along with the cost of treatment. She also offers several complementary treatments for facial rejuvenation, such as Botox to soften fine lines and wrinkles around the eyes, microneedling to improve under - eye dark circles and wrinkles, combining microneedling with platelet - rich plasma (PRP) to enhance its effects, Thermage for skin tightening in the under - eye area, chemical peels to revitalize baggy or sagging skin under the eyes, and non - ablative laser resurfacing treatments like Fraxel and Ematrix to tighten wrinkly skin and reduce pigment discoloration.
Comparing the Three Providers
| Provider | Expertise | Procedure Technique | Aftercare | Complementary Treatments | Cost Considerations |
|---|---|---|---|---|---|
| Neinstein Plastic Surgery | Experienced in plastic surgery and tear trough filler injections. Focus on safety and natural - looking results. | Deep injection on the cheekbone, moving up to the tear trough area. Uses cannulas to reduce tissue trauma. |
