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WHAT IS TEAR TROUGH The tear trough is the groove or valley that begins at the inner corner of your eyes and travels down and out across your cheek. It’s often blamed for under-eye dark circles and an aged appearance. Some doctors will even go as far to call it a “deformity”.

Why the tear trough is not a deformity The tear trough is a valley that sits atop the rim of bone that encircles the eye. This valley is a natural and normal contour that is caused by an area of compressed tissue layers. There is a thinner fatty layer over the tear trough than there is in the plumpest part of the cheek. The cheek can only look round if the surrounding areas are less round.

Tear Troughs Fillers EXAMPLE OF TEAR TROUGH Restylane is an ideal filler choice for the tear trough for many reasons. It’s unique consistency creates a natural rejuvenation in the tear trough. It is also long-lasting, often greater than a year. And finally, since it is a hyaluronic acid filler, it can be broken down with hyaluronidase injection, if necessary. Belotero is another hyaluronic acid filler that can work well in the tear trough. EXAMPLE OF TEAR TROUGH

SIDE EFFECTS OF FILLERS Unfortunately, not all fillers are well suited for the tear trough. Juvederm exerts a very hydrophilic plumping effect under the eyes, creating a very conspicuous ‘puffy’ look that can persist for several months. And while many injectors have tried filling the tear trough with collagen, Radiesse, Artefill, and even silicone, these other filler materials have been associated with unwanted side effects and poor cosmetic outcomes.

THE TEAR TROUGH AND DARK CIRCLES UNDER THE EYES The tear trough, also known as a nasojugal groove, extends from the inner corner of the eye, following a semicircular arc and transitioning to the palpebromalar groove. A deep tear trough can create a shadow that is perceived as a dark circle below the eye. It also creates a division between the lower eyelid and cheek that is an early sign of aging around the eyes. Patients with deep tear troughs often complain that they look more tired and older than they really are. EXAMPLE

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