Introduction

Tear troughs can be a common cosmetic concern, causing individuals to look tired or older than they actually are. In New York City, there are various plastic surgery options available for removing tear troughs with fat filling. This guide aims to provide comprehensive information on the topic, including what tear troughs are, the causes, treatment options, and considerations for choosing a hospital.

What are Tear Troughs?

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. As we age, the skin under the eyes can become thinner, and subcutaneous fat volume is lost, causing the tear trough area to appear more prominent, which is known as a tear trough deformity. Some individuals may also have a congenital lack of facial fat volume in the tear trough area, resulting in an under - eye hollow. This is a common cosmetic concern and can significantly affect one's appearance.

Causes of Tear Trough Deformity

The development of tear trough deformity can be attributed to a combination of factors:

• Aging: With age, the skin loses elasticity, and facial ligaments become lax. The fat that normally covers the tear trough area descends, creating a hollow in its place. The skin under the eyes is thinner and more delicate than other parts of the face, making it particularly prone to volume loss and sagging as we get older.
• Genetics: Some people are genetically predisposed to having a lack of facial fat volume in the tear trough area, resulting in under - eye hollows from a young age.
• Loss of Facial Fat: The natural loss of fat in the face over time can contribute to the deepening of tear troughs. This can be accelerated by factors such as weight loss or certain medical conditions.

Treatment Options for Tear Troughs

Dermal Fillers

Dermal fillers are a popular non - surgical option for treating tear troughs. 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. Here are some key aspects of dermal fillers for tear trough treatment:

Types of Fillers

There are several types of fillers that can be used for tear troughs. Hyaluronic acid fillers, such as Restylane® or Belotero, are commonly used because they are safe, effective, and provide natural - looking results. These fillers can be dissolved with hyaluronidase if necessary.

Benefits

Tear trough fillers offer numerous benefits:

• Reduced Appearance of Dark Circles: They can fill in the hollows that cause shadowing, reducing the appearance of dark circles.
• Camouflages Under - Eye Bags: By filling out the depression below the eye bags (the tear trough), the lower eyelid blends more seamlessly with the cheek, reducing the appearance of puffiness.
• Restores Volume: Adds volume to the under - eye area, giving a more youthful and refreshed appearance.
• Non - Surgical: No need for invasive surgery, which means less downtime and lower risk compared to surgical procedures.
• Quick Results: Results are typically visible immediately after the procedure.
• Long - Lasting: The effects can last for several months, usually around 6 - 12 months, depending on the individual and the type of filler used.

Candidates

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. Realistic expectations are also important, as the treatment can provide improvement but not perfection. It's important to note that fillers are only useful for dark circles caused by the effect of shadowing due to volume loss 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.

Procedure

Before the procedure, patients are usually asked to discuss their medical history, medications, and any allergies or sensitivities with the doctor. In the days leading up to the appointment, it's recommended to avoid taking blood - thinning medications or supplements, alcohol, and caffeine to reduce the risk of bruising. On the day of the appointment, the patient should arrive with a clean and makeup - free face. The filler is injected into the under - eye area using a small cannula, 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.

Recovery

After getting tear trough fillers, it's 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. It's 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.

Fat Transfer

Fat transfer, also known as fat micrografting or facial fat transfer, is another option for treating tear troughs. It is a more invasive surgical procedure but can provide more permanent results compared to dermal fillers. Here's how it works:

Procedure

The fat transfer process begins with liposuction to remove fat from other areas of the body, such as the abdomen, thighs, sides, or back. The liposuction procedure can be completed under local anesthesia with intravenous sedation if only a small amount of fat removal is needed, or under general anesthesia for more significant fat removal. Once the fat is removed, it is centrifuged to separate it from blood and other fluids. Then, the doctor carefully injects the prepared fat into the targeted areas of the face, including the tear troughs. A small amount of fat is added at a time to gradually build up layers until the desired amount of volume is reached.

Recovery and Results

The side effects and length of recovery mostly correspond to the liposuction portion of the procedure. If only a small amount of fat is removed, the recovery will be quicker and more comfortable. In general, patients should expect to miss one week of work and avoid exercise for two to three weeks. Common side effects include swelling, bruising, soreness, and numbness, which are mostly localized to the donor sites where fat was removed. Some mild swelling may also occur in the face around the injection sites. Side effects will diminish throughout the first couple of weeks, although swelling can take several months to completely subside. While results will be immediately noticeable, patients should expect to wait about three months before their final results have developed. Fat transfer provides lifelong results for volume restoration, although not all of the fat transferred to the face will be accepted by the body. About 50 to 80 percent of the transferred fat survives the procedure, and the rest is safely reabsorbed by the body over time. If the body absorbs too much of the fat or if patients would like to add more volume, an additional micrografting procedure can be completed after 12 months.

Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is a surgical option for treating tear troughs, especially when there are other issues such as excess skin, muscle, or fat in the lower eyelid area. Here's an overview of this procedure:

What it Entails

As we age, the lower eyelids can change in several ways. The eyelid skin loosens, creating wrinkles and crow’s feet. The orbicularis oculi muscle around the eye becomes looser and may develop “festoons.” The eyelids become puffy with excess fat pockets, and dark circles form as volume is lost in the upper cheeks. The outer corner of the eye may also droop, making the eyes appear round. Lower eyelid blepharoplasty can address these issues by removing excess skin, muscle, and fat and tightening the eyelids. There are different types of incisions for this procedure:

• Transconjunctival Blepharoplasty: An incision is made inside the eyelid. This approach is often used when there is no need to remove excess skin.
• Transcutaneous Blepharoplasty: An incision is made just below the eyelashes. This is used when a significant amount of excess skin needs to be removed.

Fat Transposition

Instead of simply removing the fat bags under the eyes, which can create a hollowed - out look, some surgeons may perform fat transposition. In this procedure, the orbital fat is transposed down into the tear trough, filling in the hollows while removing the bags in one operation. This can provide a more natural - looking result.

Canthopexy

To maintain the shape of the eyelids and prevent ectropion (drooping of the corner of the eye), a canthopexy procedure may be performed during lower eyelid blepharoplasty. The lateral canthal tendon of the lower eyelid is tightened to ensure the eyelid does not droop while it heals and to recreate the almond - shaped eyes of youth.

Recovery and Results

Lower eyelid blepharoplasty surgery takes approximately one hour to perform, but the recovery can take approximately ten days to two weeks. Bruising from the surgery lasts between 7 and 10 days, and some surgeons may prescribe special makeup to cover bruises. Following all post - surgical instructions is crucial for a successful recovery. After the recovery period, the lower eyelids will look much smoother and fuller, and the results can last 15 years or more.

Choosing a Hospital in New York City

When considering plastic surgery for removing tear troughs with fat filling in New York City, choosing the right hospital is crucial. Here are some factors to consider:

Surgeon's Experience and Reputation

Look for a board - certified plastic surgeon with extensive experience in tear trough treatments. Research their background, including their education, training, and the number of similar procedures they have performed. Patient testimonials and reviews can also provide valuable insights into the surgeon's skills and bedside manner. For example, Dr. David Cangello is a plastic surgeon with extensive experience in tear trough filler treatments and can recommend the best option based on individual needs. Dr. Gerald Imber is a world - renowned board - certified NYC plastic surgeon recognized as among the top 1% of plastic surgeons in the United States and has performed more than 3000 facelifts.

Hospital Accreditation and Facilities

Ensure that the hospital or surgical facility is accredited by a recognized organization. Accreditation ensures that the facility meets certain standards of safety and quality. Also, consider the quality of the facilities, including the operating rooms, recovery areas, and the availability of advanced technology and equipment.

Treatment Options and Customization

A good hospital should offer a variety of treatment options for tear troughs, including dermal fillers, fat transfer, and lower eyelid blepharoplasty. The surgeon should be able to assess your individual needs and develop a customized treatment plan to achieve your desired results. For example, at some practices, they take into account factors such as your skin type, the severity of the tear troughs, and your overall aesthetic goals when recommending a treatment.

Cost and Insurance

The cost of tear trough treatments can vary depending on the type of procedure, the amount of filler or fat used, and the reputation of the surgeon. It's important to get a detailed quote that includes all the costs associated with the procedure, such as the surgeon's fee, anesthesia fee, and facility fee. Some insurance plans may cover certain aspects of the surgery if it is deemed medically necessary, but most cosmetic procedures for tear troughs are considered elective and are not covered by insurance.

Post - Operative Care

Check what kind of post - operative care the hospital provides. This includes follow - up appointments, instructions for wound care and recovery, and support in case of any complications. Good post - operative care is essential for a successful recovery and optimal results.

Conclusion

Removing tear troughs with fat filling is a viable option for those looking to improve the appearance of their under - eye area and achieve a more youthful and refreshed look. In New York City, there are various treatment options available, including dermal fillers, fat transfer, and lower eyelid blepharoplasty. Each option has its own advantages and considerations, and the choice depends on individual factors such as the severity of the tear troughs, personal preferences, and budget. When choosing a hospital, it's important to consider the surgeon's experience, hospital accreditation, treatment options, cost, and post - operative care. By making an informed decision and following the recommended pre - and post - operative instructions, patients can achieve the desired results and enhance their self - confidence. If you're considering tear trough treatment, we encourage you to schedule a consultation with a qualified plastic surgeon to discuss your options and determine the best approach for you. Share this article with others who may be interested in tear trough treatment and explore more on this topic to stay informed about the latest advancements in plastic surgery.