The term “tear trough” refers to a hollowing of the area under the eyes between the eyelid and cheek. Some of us are born with deep tear trough hollowing while in others this change develops as our cheeks gradually descend due to aging. Hollowing in the tear trough area makes us look sad or tired even if we feel happy and rested. The goal of correction in this area is to smooth the transition between the lower eyelid into the cheek. In those patients who have under eye hollowing due to sagging of the cheeks, it is often necessary to correct both the cheeks and the tear trough to achieve best outcomes.
Injectable Correction
Correction of under-eye hollows is best achieved using injectable soft tissue fillers, such as Restylane. As anesthesia or sedation is not required, most patients apply a topical anesthetic (“numbing cream”) before the procedure and typically report little to no pain. Injection of the tear troughs typically takes less than 30 minutes and patients can drive themselves home after their appointment.
While soft tissue fillers are the mainstay of treatment for most patients who complain of dark circles or under-eye hollowing, skin discoloration and unwanted blood vessels can play a role in the appearance of dark circles under the eyes. Although lasers and topical skin care products do not correct the volume change associated with tear trough hollowing, for some patients they may improve the appearance of dark circles under the eyes by decreasing skin pigmentation and/or reducing the discoloration produced by the presence of underlying blood vessels.
After Treatment Care
As some bruising and swelling can occur after tear trough correction with soft tissue fillers, we recommend discontinuing aspirin and any other medications or supplements that thin the blood for several days prior to treatment. If a doctor has instructed you to take a blood thinner, please check with him/her before changing your daily medication routine.
There is very little aftercare required following correction of under-eye hollows. Cold compresses used intermittently for the remainder of the day of your treatment can help reduce the chances of developing bruising and swelling. In the event you do develop bruising after your injections, please call our office and we will arrange a complimentary laser treatment to help the bruising resolve quickly.