Learn About Tear Troughs & Causes of Under Eye Bags

The tear trough, also known as the nasojugal groove, is a small lesion of skin that runs from the inner eye to the outer corner. At times when a patient has a baggy or puffy palpebromalar groove it creates a division of skin between the lower eyelid and cheek. At our oculoplastic surgery practice, Dr. Christopher Zoumalan, MD FACS can treat patients for such conditions with tear trough fillers.

Both under eye bags and tear trough deformities can result in a tired and aged appearance. They can often occur together and both correlate with either loss of fat or a gain in fat in certain areas around the eyelid structures.

Until recently, surgery was the only method for correcting tear trough deformity or under-eye bags, but Dr. Zoumalan uses advanced techniques and injection treatments — with or without surgery — to rejuvenate this area of the face and improve the appearance.

What Causes Lower Eyelid Bags

There are various causes that result in changes to the lower lids with aging. Some people end up having dark circles and others end up having more prominent bags appear in their lower lids as they age. Under-eye bags occur with age as the naturally occurring fat pockets around the eyeball grow. With time, the fat under the eyeball tends to protrude or herniate through the thin eyelid skin.

Tear trough deformity is a problem that can be present in adults of all ages. I see them in patients as early as their 20s and also in mature adults, even up to their 70s and 80s. With age, the lower eyelid trough becomes deeper. People commonly complain of a tired look and note they have eyelid bags, puffy eyes, and under-eye bags.

Tear Trough Fillers for Lower Eyelid Bags

Facial fillers are the primary treatment for the lower eyelids, which can certainly help in improving the volume deficiency or deformity people get with aging and can reduce the amount of herniated fat visible to others. Under Eye Fillers can also help improve the appearance of hyperpigmentation that is often present in such cases. Hyaluronic acids or fat grafting in this area is a preferred solution.

About the Under Eye Bag Fillers Procedure:

The procedure is performed in the office with the assistance of a topical anesthetic. It can take as little as 30 minutes if using hyaluronic acids and patients can return home following this treatment.

Dr. Zoumalan has introduced the use of a blunt-tipped cannula for most of the facial filler injections, which helps reduce the incidence of bruising and discomfort in patients. This treatment is often performed with the use of a topical anesthetic.

The blunt-tipped cannulas used for my facial filler injections are similar to the ones used in the operating room for my fat grafting procedure, which has made the transition to using the cannulas in the office readily available.

Dark circles are present in both lower lids, right worse than left.

The patient shown above had dark circles that were present in both lower eyelids and the right eyelid was significantly worse than the left eyelid.

She received dermal fillers to the eyelid and cheek areas to build up the volume she had lost due to aging. The green dots in the third image indicate the ONLY location that the skin was pierced to perform the procedure using a blunt-tipped cannula.

This helps reduce multiple injection sites, minimize bruising, discomfort, and swelling. The blue dots indicate where the filler was injected and the red dots indicate where the filler was injected.

Make Dr. Zoumalan Your Choice for Tear Trough Fillers

Oculoplastic surgery is a passion of ours and we take pride in helping patients improve the appearance without the use of invasive surgery. If you find that your eyelids are lacking ideal volume and in need of tear trough correction then fill out our consultation form to get in touch with Dr. Zoumalan. Tear trough fillers are performed routinely at our practice.

Common Questions about Under Eye Bag Fillers

Are under eye fillers right for me?

Candidates for this procedure may have puffy eyes, eye bags, and dark circles. Candidates should be in good health and have realistic expectations for this procedure. Patients will meet with Dr. Zoumalan for a one-on-one consultation to determine their candidacy for the under eye fillers. A thorough exam of the under eye area will be performed during this appointment. Patients will discuss their ideal aesthetic and outcome for this treatment with Dr. Zoumalan. A customized treatment plan will be created based on the patient’s goals and Dr. Zoumalan’s expertise. Dr. Zoumalan will carefully explain all details of the procedure and recovery with the patient.

What Happens During the Procedure?

The under eye bag filler procedure is performed with a topical anesthetic. This treatment takes around 30 minutes to perform. Dr. Zoumalan will use a blunt-tipped cannula to carefully inject filler into the under eye area. Blunt-tipped cannulas are a safe option used to significantly reduce discomfort and decrease bruising. Injections will be strategically placed to reach the desired aesthetic. A topical anesthetic will also be administered to reduce any discomfort.

What is the recovery time for under eye fillers?

The under eye filler treatment requires little to no downtime. Patients can resume most normal activities immediately after the procedure. Exercise should be held for 24 hours along with other strenuous activities. Healing time varies based on the treatment needed. Patients may experience slight swelling, minimal pain, redness and itching. Swelling usually subsides within a few days of the procedure. Patients should avoid exposure to heat and sunlight. Dr. Zoumalan will schedule a follow-up appointment two weeks after the treatment to monitor the patient’s recovery process. Patients may discuss any concerns or questions about recovery during this appointment. Dr. Zoumalan is dedicated to ensuring each patient has a seamless treatment at his practice. Results can be seen immediately after the procedure and may last up to one year.

Preoperative diagnosis: Lower lid fat prolapse (ie bags under eyes). History of prior blepharoplasty with residual fat pads. Loss of midface volume.

Procedure performed: Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface. In this patient, Restylane was used around the tear trough and orbital rim. Juvederm was used to augment the midface and to restore the volume that had been lost. Pre and post photos are shown above.

Preoperative diagnosis: Tear trough deformity (orbital rim hollowying) and loss of midface volume. The patient has visible eye bags, right worse than left. The dark shadows are a result of a loss of volume in the tear trough and also a result of “extra” fat that has herniated.

Procedure performed: Hyaluronic acid (HA) fillers to orbital rim (tear trough) and midface.

Disclaimer:

*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.

Common Questions and Answers

Dr. Christopher Zoumalan is a board-certified oculoplastic surgeon in Beverly Hills, specializing in aesthetic and reconstructive oculoplastic surgery. Dr. Zoumalan is passionate about helping patients reach their ideal aesthetic and restore functionality with the leading cosmetic eyelid surgery, reconstructive eyelid surgery, and non-surgical cosmetic procedures. Dr. Zoumalan has been featured on several television shows and has traveled the world as a trusted oculoplastic specialist. Browse the video gallery below to learn more about oculoplastic procedures and treatments.