Introduction
Tear troughs, the creases under the eyes, can make one look tired and aged. Tear trough filling has emerged as a popular non - invasive cosmetic solution to address this concern in New York City. This article aims to provide a detailed comment on the top 5 doctors for tear trough filling in the city, based on their expertise, patient reviews, and the variety of treatments they offer. We'll also delve into the basics of tear trough filling and other relevant information.
Understanding Tear Trough Filling
What are Tear Troughs?
A tear trough is an anatomic area in the face, specifically the hollow located between the upper cheek and the lower eyelid region. It can cast a shadow and create the appearance of a darkened under - eye area, making one look tired or prematurely aged. Tear troughs can be genetic, but they may also occur due to the natural loss of collagen that happens 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.
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. Dermal fillers, often composed of hyaluronic acid gel, are used. 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.
Types of Fillers for Tear Troughs
- Juvederm Volbella: The first FDA - approved dermal filler for treating tear troughs. It contains the thinnest formulation of the Juvederm family. Its patented Vycross technology allows for the dermal filler to have a smooth and even distribution under the skin.
- Restylane: A well - established brand. Restylane Eyelight is a newer dermal filler that 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: Provides a soft and even correction in the skin. It has an ultra - thin and flexible formulation that can eliminate the risk of developing the Tyndall effect, which can create a bluish hue in the injected area due to the reflection of light off of particles suspended in the filler.
The Top 5 Doctors for Tear Trough Filling in New York City
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 for various skin concerns, including dark under - eyes. She is consistently rated as a top NYC dermatologist by Castle Connolly, Super Doctors, New York Magazine, and The New York Times.
Expertise and Approach
Dr. Green offers a host of non - invasive cosmetic procedures for rejuvenation, including under - eye fillers, Botox, laser treatments, microneedling, other various dermal fillers, chemical peels, and more. When it comes to tear trough filling, she is an expert injector who can work with patients to ensure they are a good candidate and develop a customized treatment plan that caters to their unique skin care concerns and aesthetic goals. She often uses hyaluronic acid fillers such as Juvederm Volbella, Restylane, Restylane Eye Light, and Belotero Balance. Dr. Green takes a "less - is - more" approach to dermal fillers, being extremely careful not to overfill the delicate under - eye area.
Patient Experience
Patients can trust that they have a provider with the skill and knowledge to provide them with the most phenomenal, natural - looking, long - lasting cosmetic results. During the consultation, Dr. Green assesses the under - eye hollows to choose the right tear trough filler for the patient. She also conducts a two - week follow - up to ensure that the treatment was satisfactory and determine whether any touch - up of the hyaluronic acid dermal filler is needed.
Cost and Safety
The cost of the tear - trough filler treatment with Dr. Green depends on several factors, such as the type of filler used and the amount of filler needed. While it may be more costly compared to some other providers, it is important to choose an experienced, board - certified dermatologist to avoid unwanted side effects. There typically are no major side effects associated with receiving under - eye fillers from Dr. Green, but minor swelling or bruising may occur, which can be minimized with proper aftercare.
Dr. Brett Kotlus
Dr. Brett Kotlus is a cosmetic oculoplastic surgeon in NYC with extensive experience and specialized training in oculoplastic and cosmetic surgery.
Expertise and Approach
Dr. Kotlus has a detailed understanding of the different types of under - eye fillers. He does not recommend using permanent or semi - permanent injectable fillers under the eyes, such as Bela Fill, Radiesse, silicone, and Sculptra, as they are not reversible and can cause problems if not placed correctly. For the vast majority of people, he recommends cross - linked hyaluronic acid (HA) gel fillers. He still chooses Restylane - L as the best under - eye filler because of its great behavior profile, with the right balance of stiffness, cohesivity, duration of effect (about a year under the eyes), and relatively low swelling. He also uses other HA fillers like Belotero Balance, Juvederm Volbella, and Juvederm Vollure, depending on the patient's needs.
Patient Experience
Dr. Kotlus addresses patients' concerns about under - eye fillers and is able to correct unwanted results from previous filler treatments. He helps patients choose the most suitable filler or combination of fillers based on their individual facial anatomy and aesthetic goals.
Cost and Safety
The cost of tear trough filling with Dr. Kotlus will depend on the type and amount of filler used. His approach emphasizes safety, and he is able to dissolve the filler if there are any issues using an enzyme injection, which shows his commitment to patient satisfaction and safety.
Dr. George Liakeas
Dr. George Liakeas is the medical director at Smooth Synergy Medical Spa & Laser Center. The spa is known for offering a complete line of non - surgical facial treatments, including tear trough filler.
Expertise and Approach
Dr. Liakeas uses hyaluronic acid (HA) filler for tear trough treatment. The procedure is simple and usually takes between 15 minutes to an hour, depending on the treatment area. He evaluates the face and marks strategic injection points for placement. Using a super - fine needle, he injects along these predetermined sites and then evaluates the treatment area to assess whether additional filler is needed to assure maximum benefit to the skin.
Patient Experience
Patients who are concerned about pain can be assured that Dr. Liakeas is trained and experienced in injecting the product quickly and easily. He may anesthetize the treatment area with a numbing cream, and there are fillers that contain a numbing ingredient, such as lidocaine, to minimize discomfort. Most patients can return to normal activity immediately after the injection, and severe after - effects are uncommon.
Cost and Safety
The cost of tear trough filler treatment at the spa will depend on the filler used. Cosmetic fillers have a long - standing track record of safety, and they are biocompatible, virtually eliminating the risk of allergic reaction. However, it is important to note that tear trough treatment is an off - label use for dermal fillers, which is why it is crucial to have the procedure done by a properly vetted doctor like Dr. Liakeas.
Dr. Darren M. Smith
Dr. Darren M. Smith is a board - certified plastic surgeon with an artistic eye for aesthetics. He has over 18 years of experience and is considered one of the leading specialists in enhancing and rejuvenating the delicate eye region.
Expertise and Approach
Dr. Smith offers tear trough fillers as a targeted solution for revitalizing the under - eye area. He uses hyaluronic acid gel fillers like Juvederm and Restylane. He carefully determines the ideal filler to meet each patient's individual needs. He also pays attention to the differences between tear trough fillers and general under - eye fillers, using appropriate techniques for the tear trough region, such as injecting the filler deep, just above the orbital bone, for a natural appearance without surface lumpiness.
Patient Experience
Patients report dramatic yet natural - looking results after tear trough filler treatment with Dr. Smith, looking 5 - 10 years younger. He provides personalized care and discusses risks and post - treatment care with patients. He also uses advanced techniques like small injection amounts and cannulas to minimize trauma and reduce the chances of extensive bruising.
Cost and Safety
The average cost for tear trough filler treatment with Dr. Smith depends on the type of filler used and the amount of filler needed. When performed properly by an experienced provider like him, tear trough fillers are safe with minimal risks. However, he takes every precaution for patient safety and discusses risks beforehand.
Dr. Zuckerman
Dr. Zuckerman is a board - certified plastic surgeon who can help patients reduce dark circles with under - eye dermal filler injections.
Expertise and Approach
For the sensitive under - eye area, Dr. Zuckerman uses Restylane - L, a hyaluronic acid filler with lidocaine, which is FDA - approved for treating the under - eye area. It is also the least hydrophilic of hyaluronic acid fillers, minimizing swelling. He injects deep into the tissues, near the bone, and can inject up to 1 cc + of filler per eye.
Patient Experience
Treatment with Dr. Zuckerman helps patients appear rested and refreshed. The treatment is visible immediately, but it takes approximately one week to ten days to set in. Most patients require one treatment per year to maintain a continual effect. There may be mild bruising or swelling, which usually resolves within a few days to a week. Dr. Zuckerman is able to minimize bruising using his techniques and also by icing the affected area post - treatment.
Cost and Safety
The cost of tear trough filling with Dr. Zuckerman will depend on the amount of filler used. While this treatment is overwhelmingly safe in the hands of an expert injector like him, he recommends visiting a board - certified plastic surgeon for tear trough filler treatment due to the more advanced injection technique required in this sensitive area.
Comparison of the Top 5 Doctors
| Doctor | Specialty | Preferred Fillers | Patient Experience Highlights | Cost Considerations | Safety Precautions |
|---|---|---|---|---|---|
| Dr. Michele Green | Cosmetic Dermatology | Juvederm Volbella, Restylane, Restylane Eye Light, Belotero Balance | Customized treatment plans, two - week follow - up | Depends on filler type and amount; higher cost for experience | Minimizes major side effects; experienced injector |
| Dr. Brett Kotlus | Cosmetic Oculoplastic Surgery | Restylane - L, Belotero Balance, Juvederm Volbella, Juvederm Vollure | Addresses filler - related concerns, chooses fillers based on patient needs | Depends on filler type and amount | Avoids non - reversible fillers, can dissolve fillers if needed |
| Dr. George Liakeas | Medical Director at Spa | Hyaluronic acid fillers | Minimizes pain, quick recovery time | Depends on filler used | Properly vetted, uses biocompatible fillers |
| Dr. Darren M. Smith | Plastic Surgery | Juvederm, Restylane | Personalized care, natural - looking results, minimizes bruising | Depends on filler type and amount | Experienced, discusses risks |
| Dr. Zuckerman | Plastic Surgery | Restylane - L | Visible results, minimal bruising | Depends on filler amount | Expert injector, advanced injection technique |
Other Considerations for Tear Trough Filling
Candidates for Tear Trough Filling
The best candidates for dermal filler injections in the tear trough 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 course of treatment. It is important to consult with a doctor to determine if this treatment is suitable.
Procedure and Recovery
Before the procedure, patients usually need to avoid blood - thinning medications and alcohol to reduce the risk of bruising. The injection process may involve the application of a local anesthetic to minimize discomfort. After the procedure, mild swelling, bruising, and redness are common, but they usually subside within a few days to a week. Patients are advised to avoid rubbing or massaging the area and strenuous exercise for a certain period.
Side Effects and Reversibility
Common side effects of tear trough filling include swelling, bruising, redness, and in rare cases, the Tyndall effect. The fillers used are often made of hyaluronic acid, which can be reversed using hyaluronidase if the patient is not satisfied with the results.
Conclusion
In conclusion, tear trough filling is a popular and effective non - invasive cosmetic procedure for rejuvenating the under - eye area in New York City. The top 5 doctors mentioned - Dr. Michele Green, Dr. Brett Kotlus, Dr. George Liakeas, Dr. Darren M. Smith, and Dr. Zuckerman - each bring their own unique expertise, preferred fillers, and patient - centered approaches to tear trough filling. They all prioritize safety and strive to provide natural - looking, long - lasting results for their patients. When considering tear trough filling, it is crucial to research these doctors, have in - depth consultations, and choose the one that best suits your individual needs and aesthetic goals.
If you are interested in tear trough filling, we encourage you to reach out to these top doctors for consultations. Take the time to discuss your concerns, ask questions about the procedure, and get a clear understanding of what to expect. You can also read more about cosmetic dermatology and plastic surgery advancements to stay informed about the latest trends and techniques. Don't hesitate to share this article with friends or family who may also be interested in tear trough filling, and continue exploring related topics to make the best decision for your beauty and well - being.
