Introduction

The appearance of the under - eye area plays a crucial role in one's overall facial aesthetics. Tear troughs, those hollows between the lower eyelid and upper cheek, can make a person look tired and aged. Autologous fat filling of tear troughs has emerged as a popular solution in New York City. In this article, we will explore the top three authorized hospitals for this procedure, and also cover everything you need to know about tear troughs, the fat - filling procedure, and more.

What are Tear Troughs?

Tear troughs are an anatomical area of the face. They are the hollows located between the upper cheek and the lower eyelid region. These can cast a shadow and create the appearance of a darkened under - eye area, leading to a tired or prematurely aged look. There are several factors that can contribute to the development of tear troughs:

• Genetics: Some people are born with a predisposition to more prominent tear troughs. Their facial structure and fat distribution from birth can result in these hollows being more visible even at a young age.
• Aging: As we age, the natural loss of collagen occurs. In the under - eye area, reduced collagen levels lead to transparent, thin skin. This makes the underlying blood vessels more visible, contributing to the darkened appearance. Also, the subcutaneous fat volume is lost, and the skin elasticity decreases, causing the tear trough area to become more prominent.

Tear Trough Fillers: An Overview

How Tear Trough Fillers Work

Tear trough fillers restore lost volume in the crease below the eye and improve the appearance of dark circles and under - eye bags. Most commonly, hyaluronic acid - based fillers are used. Hyaluronic acid is a substance that occurs naturally in the body. When injected into the tear trough area, it binds to water, plumping the skin and increasing collagen production. This results in a more youthful - looking complexion, reducing the appearance of fine lines, puffiness, and dark circles.

Benefits of Tear Trough Fillers

• Non - surgical: It is a non - invasive alternative to plastic surgery, which means less downtime and fewer risks associated with surgery.
• Natural - looking results: When done correctly, the results can be very natural, enhancing the appearance without looking over - done.
• Long - lasting: Although not permanent, the effects can last from six to twelve months, depending on the type of filler used and individual factors such as metabolism.
• Quick results: The changes are usually visible immediately after the injection.

Types of Tear Trough Fillers

Autologous Fat Filling for Tear Troughs

What is Autologous Fat Filling?

Autologous fat filling, also known as autologous fat grafting or fat transfer, involves taking fat from one's own body (usually from the abdomen, hips, or thighs), processing it, and then injecting it into the tear trough area. This is a more natural alternative to synthetic fillers as it uses the patient's own tissue, reducing the risk of allergic reactions.

Advantages of Autologous Fat Filling

• Natural material: Since it uses the patient's own fat, there is no risk of rejection or allergic reaction.
• Long - term results: Once the fat cells survive, the results can be long - lasting compared to some other fillers.
• Improves skin quality: The fat contains stem cells that can improve the quality of the surrounding skin.

The Procedure of Autologous Fat Filling

1. Harvesting: Fat is harvested from a donor site, typically using a small cannula. The area to be suctioned is infiltrated with a solution to reduce pain and bleeding. It is important to use an atraumatic technique to ensure the viability of the fat cells. For example, a blunt atraumatic fat grafting cannula is often preferred over conventional liposuction methods. A 2 mm diameter cannula with a blunt tip and several side holes connected to a 10cc syringe is found to be favorable for aspiration as it yields better viability of fat grafts compared to other setups.
2. Processing: The harvested fat needs to be processed to remove blood, oil, and other impurities. The most common method is centrifugation at 3000 rpm (about 1289 g) for 3 minutes. This helps to separate the pure fat from the other components and may maintain a higher concentration of stem cells within the processed lipo - aspirates.
3. Injection: The processed fat is then injected into the tear trough area. A small amount (about 0.1 cc) is injected with every pass in an intermittent retrograde pattern at various different levels. This ensures that the fat grafts have a maximal amount of contact with the vascularized tissue in the grafted area for better survival.

The Top Three Authorized Hospitals for Autologous Fat Filling of Tear Troughs in New York City

Hospital 1: Dr. Michele Green's Private Dermatology Office

Expertise

Dr. Michele Green is a world - renowned expert in the field of cosmetic dermatology, with over 25 years of experience treating patients from around the globe for various skin concerns. She is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. When it comes to tear trough fillers, she has in - depth knowledge of different filler types and their applications. In the case of autologous fat filling, she can use her extensive experience in cosmetic procedures to ensure the best results for patients. Her approach is personalized, taking into account the patient's unique skin care concerns and aesthetic goals.

Procedure Process

During the consultation, Dr. Green will assess the patient's under - eye hollows, skin condition, and overall facial anatomy. She will determine if autologous fat filling is the right option for the patient. If so, she will guide the patient through the entire process, from the preparation stage (such as discontinuing certain medications to reduce the risk of bruising) to the actual harvesting and injection. After the procedure, she will closely monitor the patient during the follow - up appointments to ensure proper healing and optimal results.

Patient Reviews

Patients appreciate Dr. Green's professionalism, expertise, and attention to detail. They often mention that they feel comfortable during the consultation and procedure, and are satisfied with the natural - looking results. Many patients have reported a significant improvement in the appearance of their under - eye area, looking more rested and youthful.

Hospital 2: Dr. David Cangello's Practice

Expertise

Dr. David Cangello is a plastic surgeon with extensive experience in tear trough filler treatments. He understands the complex anatomy of the under - eye area and can accurately assess the patient's needs for autologous fat filling. He is well - versed in selecting the appropriate donor site for fat harvesting and using the best techniques for processing and injecting the fat to achieve beautiful and natural results.

Procedure Process

Before the procedure, Dr. Cangello will have a detailed consultation with the patient to understand their goals and medical history. He will also provide instructions on how to prepare for the autologous fat filling, such as avoiding blood - thinning medications and supplements. During the procedure, he uses advanced techniques to minimize discomfort and ensure the safety of the patient. After the injection, he will provide clear after - care instructions to manage any swelling or bruising and to promote proper recovery.

Patient Reviews

Patients praise Dr. Cangello for his patience, his ability to explain the procedure in detail, and his skill in performing the autologous fat filling. They often report that they received excellent care throughout the process and are happy with the final outcome, with an improved appearance of the under - eye area and a more refreshed look.

Hospital 3: Neinstein Plastic Surgery

Expertise

Neinstein Plastic Surgery has a team of experienced professionals dedicated to providing high - quality cosmetic procedures. Their approach to autologous fat filling of tear troughs is based on years of research and clinical experience. They understand the importance of a precise injection technique to achieve natural results and to minimize the risk of complications.

Procedure Process

Patients at Neinstein Plastic Surgery are asked to avoid using blood thinners like aspirin for 5 days before the procedure. On the day of the injections, the skin is numbed for 20 minutes. The fat is harvested using a deep - injection technique, starting almost directly on the cheekbone and moving a small wave of hyaluronic acid (in this case, the patient's own fat) up towards the tear trough area. This technique is designed to be safe, predictable, and to dramatically reduce the risk of bruising. After the injections, ice is placed on the eyes for 5 minutes, and the patient takes a one - time dose of steroids to reduce swelling.

Patient Reviews

Patients appreciate the attention to detail and the focus on patient comfort at Neinstein Plastic Surgery. They report that the procedure was relatively painless, and the recovery process was smooth. Many are pleased with the long - lasting results of the autologous fat filling, which have given them a more youthful appearance.

Pre - procedure Considerations for Autologous Fat Filling of Tear Troughs

Consultation

It is essential to have a thorough consultation with a qualified doctor. During this consultation, the doctor will assess your overall health, medical history, and the condition of your tear troughs. They will also discuss your aesthetic goals and determine if autologous fat filling is the right option for you. Be honest about any medications you are taking, allergies you may have, and any previous cosmetic procedures.

Preparation

• Medication: Stop taking blood - thinning medications such as aspirin, ibuprofen, and fish oil for at least 1 - 2 weeks before the procedure to reduce the risk of bruising. Some herbal supplements may also need to be stopped.
• Lifestyle: Avoid excessive alcohol and caffeine intake in the days leading up to the procedure. Also, get enough rest and maintain a healthy diet to promote a better recovery.
• Donor Site: If you are having autologous fat filling, the doctor will discuss the donor site options with you. Make sure you understand the process and potential side effects at the donor site.

Post - procedure Care and Recovery

Immediate Post - procedure

After the autologous fat filling of tear troughs, it is normal to experience some swelling, bruising, and redness around the injection site. Ice packs can be applied to the area to reduce swelling. Avoid rubbing or massaging the area for at least 24 hours to prevent the fat from shifting. Also, avoid strenuous exercise, alcohol, and blood - thinning medications or supplements for at least 24 hours.

Long - term Recovery

Swelling and bruising usually subside within a few days to a week. It may take up to two weeks for the under - eye filler to fully settle, and the final results to be observed. Follow the doctor's after - care instructions carefully, which may include gentle cleansing of the face and avoiding exposure to extreme temperatures. You may also be advised to use a mild moisturizer to keep the skin hydrated. The doctor will schedule follow - up appointments to monitor your progress and determine if any touch - ups are needed.

Potential Risks and Complications

Common Risks

• Swelling and Bruising: This is the most common side effect. It usually resolves on its own within a few days to a week. Using ice packs and following the post - procedure care instructions can help minimize these symptoms.
• Tyndall Effect: Although less common with autologous fat filling, it can occur if the fat is injected too superficially. This causes a bluish discoloration in the injected area and may last for several months. In some cases, it can be reversed with the use of certain treatments.
• Asymmetry: There is a risk of slight asymmetry in the tear trough area. This may be due to uneven fat distribution during the injection or different rates of fat absorption. A follow - up touch - up procedure may be required to correct this.

Serious Complications

• Vascular Occlusion: This is a rare but serious complication. It occurs when the injected fat blocks a blood vessel, which can lead to tissue damage and even blindness in severe cases. It is crucial to have the procedure performed by an experienced doctor who knows how to avoid this complication.
• Infection: Although the risk is low, there is a possibility of infection at the injection site or the donor site. Signs of infection include increased pain, redness, swelling, and pus. If you notice any of these symptoms, contact your doctor immediately.
• Fat Necrosis: This can happen when the fat cells do not receive enough blood supply and die. It may result in contour irregularities and lumps in the treated area. Treatment may involve further surgical procedures to correct the problem.

Conclusion

Autologous fat filling of tear troughs is a great option for those looking to rejuvenate their under - eye area and achieve a more youthful appearance. The top three authorized hospitals in New York City - Dr. Michele Green's Private Dermatology Office, Dr. David Cangello's Practice, and Neinstein Plastic Surgery - offer high - quality services with experienced professionals. However, like any cosmetic procedure, it is important to understand the process, potential risks, and follow the pre - and post - procedure care instructions. By making an informed decision and choosing a qualified doctor, you can expect to see significant improvements in the appearance of your tear troughs.

If you are considering autologous fat filling of tear troughs, we encourage you to schedule a consultation with one of the recommended hospitals. Explore your options, ask questions, and take the first step towards a more refreshed and youthful you. Share this article with your friends and family who may also be interested in this procedure.