Introduction
The under - eye area, particularly the tear troughs, can be a tell - tale sign of aging, fatigue, and genetic factors. Dark circles, hollowness, and puffiness under the eyes can make a person look older and more tired than they actually are. Hyaluronic acid filling of tear troughs has emerged as a popular non - surgical solution to address these concerns, providing a more youthful and refreshed appearance. In New York City, a hub of cosmetic treatments, there are several well - reputed institutions and experts in this field. This article carefully selects three such options and also delves into everything you need to know about hyaluronic acid filling of tear troughs.
What are Tear Troughs?
The tear trough is the hollow area under the lower eyelid between the lower lash line and the cheekbone. As we age, this area loses volume, and various factors can contribute to its prominence. Genetics play a significant role; some individuals are born with a more pronounced tear trough. Aging leads to a decrease in fat and collagen under the eyes, making the trough more sunken. Sleep deprivation, allergies, and sun damage can also exacerbate the appearance of the tear trough over time. Under - eye creams may offer temporary hydration but cannot replace the lost volume.
Why Choose Hyaluronic Acid Filling for Tear Troughs?
- Minimize Dark Circles: By filling in the hollowness, hyaluronic acid fillers can reduce the appearance of dark circles caused by shadows from the sunken area.
- Reduce Bags and Puffiness: They can smooth out the under - eye area, making bags and puffiness less noticeable.
- Youthful Appearance: Restore volume to give a well - rested and youthful look, taking years off one's appearance.
- Collagen Boost: Hyaluronic acid can stimulate collagen production, which helps maintain the results over a longer period.
- Minimal Downtime: Unlike surgical procedures, hyaluronic acid filler treatments usually require little to no downtime, allowing patients to resume their daily activities quickly.
Three Well - Reputed Institutions and Experts in New York City
1. Dr. Darren M. Smith
Dr. Darren M. Smith is a board - certified plastic surgeon with over 18 years of experience, especially in enhancing and rejuvenating the delicate eye region. He provides tear trough fillers at his state - of - the - art facility located in the Ritz Tower, Manhattan, New York. Dr. Smith stays updated with the latest treatments and techniques, focusing on a natural, refreshed appearance. He uses a targeted approach for revitalizing the under - eye area. For the tear trough filler procedure, he injects hyaluronic acid gel beneath the thin skin under the eyes using a very fine needle or cannula. He carefully selects the appropriate filler, such as Restylane or Juvederm, based on the patient's individual needs. His patients often report looking 5 - 10 years younger after the treatment. The multitude of 5 - star reviews he has received is a testament to his exceptional patient care and satisfaction.
2. Dr. Michele Green
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. She has an office on the upper east side of Manhattan. Dr. Green is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times. She offers a host of non - invasive cosmetic procedures for rejuvenation, including under - eye fillers. For tear trough fillers, she often uses hyaluronic acid fillers such as Juvederm Volbella, Restylane, Restylane Eye Light, and Belotero Balance. She has a personalized approach, first assessing the patient's under - eye hollows to choose the right filler and determine the number of syringes required. Her “less - is - more” approach to dermal fillers helps in achieving natural - looking results. She also provides comprehensive after - care instructions to minimize side effects and ensure the best outcome.
3. Dr. David Cangello
Dr. David Cangello is a plastic surgeon with extensive experience in tear trough filler treatments. His New York City office is where patients can receive this treatment. He understands that each patient has unique needs and goals, and he develops a customized treatment plan accordingly. He uses hyaluronic acid - based fillers like Restylane or Belotero to address the under - eye hollows and dark circles. Before the procedure, he discusses the patient's medical history, medications, and any allergies. He recommends avoiding blood - thinning medications and alcohol in the days leading up to the appointment to reduce the risk of bruising. During the procedure, he injects the filler into the under - eye area using a small cannula, and the results are typically visible immediately. He also provides detailed post - treatment care instructions to manage swelling, bruising, and other potential side effects.
Popular Hyaluronic Acid Fillers for Tear Troughs
Restylane Family
- Restylane: A well - established brand in the field of dermal fillers, it is a popular choice for rejuvenating the under - eye area. It has the right balance of stiffness, cohesivity, and duration of effect, with relatively low swelling. It can also be adjusted for deep or shallow injections through hydration.
- Restylane Lyft: Beyond correcting age - related volume loss, it is renowned for addressing fine lines, wrinkles, nasolabial folds, and under - eye hollows.
- Restylane Refyne: A study found it effectively treated tear trough deformity, with most patients maintaining results for up to 12 months. It has a different type of crosslinking, making it more “flexible” in areas with facial movement, but its benefit for the under - eyes compared to regular Restylane is still being explored.
- Restylane Silk: The thinnest and softest version of Restylane, but it has a high swelling capacity, which may not be ideal for the thin under - eye skin.
Juvederm Family
- Juvederm Volbella XC: The first and only FDA - approved hyaluronic acid filler for the under - eye hollows. It offers a refreshed, less fatigued appearance and has a soft formulation for a natural look.
- Juvederm Voluma XC: While primarily used to augment cheek volume, in skilled hands, it can also address midface volume loss, but it may not be the best option for under - eyes due to its thickness.
- Juvederm Vollure: Stiffer than Volbella, it is a good option for deeper injections under the eyes, and it causes less swelling compared to some older Juvederm products.
Belotero Balance
It provides a soft and even correction in the skin. Its ultra - thin and flexible formulation can eliminate the risk of the Tyndall effect, a bluish discoloration that can occur with some hyaluronic acid fillers. However, it may not provide great lift for deep tear troughs.
The Tear Trough Filler Procedure
Consultation
Before the procedure, a consultation with the doctor is crucial. The doctor will assess the patient's under - eye area, discuss their goals, and determine if tear trough fillers are the right treatment. They will also consider the patient's medical history, allergies, and any medications they are taking. During this time, the doctor will explain the procedure, the type of filler to be used, the expected results, and the potential risks and side effects.
Pre - procedure Preparation
Patients are usually advised to avoid blood - thinning medications such as aspirin, ibuprofen, and fish oil for a few days before the procedure to reduce the risk of bruising. They may also be asked to avoid alcohol and caffeine in the days leading up to the appointment. On the day of the procedure, it is recommended to arrive with a clean and makeup - free face.
The Injection Process
A numbing cream is typically applied to the under - eye area about an hour before the injection to maximize comfort. The doctor will then use a very fine needle or a cannula to inject the hyaluronic acid filler beneath the thin skin under the eyes. The filler is injected at a specific depth, usually just above the orbital bone for tear trough fillers, to achieve a natural appearance without surface lumpiness. The amount of filler injected depends on the patient's individual needs and the severity of the tear trough deformity. The procedure usually takes 15 - 30 minutes to complete.
Post - procedure Care
After the injection, ice may be applied to the treatment area to reduce swelling. Patients may experience some temporary redness, swelling, or bruising, which typically resolves within a few days. They are advised to avoid rubbing or massaging the area for at least 24 hours after the procedure to prevent the filler from shifting. Strenuous exercise, alcohol, and blood - thinning medications or supplements should also be avoided for at least 24 hours. The doctor may schedule a follow - up appointment a few weeks after the procedure to evaluate the results and determine if any touch - ups are needed.
Effectiveness and Duration of Results
Tear trough fillers are one of the most effective non - surgical treatments for rejuvenating the under - eye area. The results are immediate, and patients can see a reduction in dark circles, bags, and puffiness right after the treatment. However, it may take a week or two for the swelling and bruising to completely subside, and for the final results to be fully visible. Most patients can expect the results to last between 6 to 18 months, depending on the individual and the type of hyaluronic acid gel used. To maintain the rejuvenated look, periodic maintenance treatments are advised.
Safety and Side Effects
Safety
When performed by an experienced and qualified provider, tear trough filler treatments are generally safe. However, it is crucial to have the procedure done by a medical professional trained in delicate under - eye enhancements. Injecting filler incorrectly into blood vessels in this region can lead to rare but serious complications, such as vascular occlusion, which can cause tissue damage or even vision problems. Therefore, a skilled doctor will take every precaution to ensure the patient's safety and will discuss the risks beforehand.
Common Side Effects
- Bruising and Swelling: Some minor bruising or swelling is common after tear trough filler injections. This usually resolves quickly, and techniques like using small injection amounts and cannulas can help minimize trauma and reduce the chances of extensive bruising. Applying ice packs after the procedure can also help alleviate these symptoms.
- Redness: Redness at the injection site is a temporary side effect that typically fades within a few hours to a couple of days.
- Tyndall Effect: This is a rare side effect where a bluish discoloration may appear in the injected area if the hyaluronic acid filler is injected too superficially. It can last several months but can be reversed with hyaluronidase to dissolve the dermal filler.
- Allergic Reaction: Although rare, some patients may have an allergic reaction to the filler. Signs of an allergic reaction include itching, hives, or swelling beyond the normal post - injection level. In case of an allergic reaction, immediate medical attention should be sought.
Cost of Tear Trough Fillers
The average cost for tear trough filler treatment depends on several factors, such as the type of filler used, the amount of filler needed for the treatment, the medical professional performing the procedure, and the geographic location of the office. Typically, fillers cost $1000 or more per syringe, and many patients require 1 - 2 syringes per treatment session. More expensive fillers do not necessarily produce better results. During the consultation, the doctor's office staff will provide the patient with an accurate quote based on their specific needs.
Complementary Treatments
Botox
Botox is often used in conjunction with tear trough fillers for comprehensive eye rejuvenation. It can soften the appearance of fine lines and wrinkles around the eyes, such as crow's feet. Botox works by blocking the neurotransmitters that cause muscle contractions, relaxing the muscles and reducing the appearance of wrinkles. Dr. Michele Green often treats patients for tear troughs and crow's feet in the same visit, using dermal filler and Botox to achieve total rejuvenation of the eye area.
Microneedling
Microneedling can improve under - eye dark circles and wrinkles. It uses a tool with tiny surgical - grade needles to create microscopic wounds on the surface layer of the skin. Through the natural wound - healing process, new collagen and elastin are produced, which helps to plump and firm the skin. Combining microneedling with platelet - rich plasma (PRP) can further enhance the effects, as PRP contains cytokines and growth factors that promote cellular regeneration.
Thermage
Thermage is the gold standard in facial skin tightening. It uses radiofrequency energy to stimulate collagen production in the skin, improving skin elasticity in the delicate under - eye area. It can be used to address skin laxity and give a non - surgical brow lift. The results can last up to two years, and it can be paired with other treatments like tear trough fillers and Botox.
Chemical Peels
Chemical peels can revitalize baggy or sagging skin under the eyes by removing dead skin cells and allowing healthy new skin cells to be exposed. For the under - eye area, a specialized chemical peel like the Mesopeel Periocular® can be used to reduce fine lines, hyperpigmentation, and discoloration.
Conclusion
Hyaluronic acid filling of tear troughs is an effective non - surgical option for rejuvenating the under - eye area, providing a more youthful and refreshed appearance. In New York City, there are several well - reputed institutions and experts, such as Dr. Darren M. Smith, Dr. Michele Green, and Dr. David Cangello, who can offer high - quality treatments. By understanding the procedure, the types of fillers, the potential risks and side effects, and the associated costs, patients can make an informed decision. However, it is essential to consult with a qualified professional to determine the best treatment plan for individual needs. If you're interested in enhancing your under - eye area and achieving a more youthful look, don't hesitate to schedule a consultation with one of these experts. Take the first step towards revitalizing your appearance and boosting your confidence today!
