Blepharoplasty or Tear Trough Depression?
Hi folks!
I always had a problem with under eyebags and finally considering getting it fixed.
I think it has partly been caused by allergies.
When I was younger, my eyes would get big and puffy and sore consistently.
I considered a Blepharoplasty but then fairly nervous about that and just found out about
tear trough depression.
I would prefer the non-invasive route but which do you recommend and will it have a
big effect?
Thanks so much for your advice!
Thank you for your question!
So it's clear that you are aware that you have puffy bags under your eyes and that you
were naturally concerned of having blepharoplasty and now you've learned about the world tear
trough and whether or not it would be beneficial to you.
Well I'll share with you some straight forward anatomy and as well as what the realities
of correcting the tear trough is.
First of all, the tear trough this area is an area of relative depression adjacent to
the puffy eyebags.
So a few years ago, hyaluronic acid became the treatment of choice and hyaluronic acid
such as restylane, juvederm.
These are basically gels that are made of hyaluronic acid were used to place underneath
and quickly these became the non-surgical eye lift.
And people were running around especially non-surgical physician celebrating that they
found the holy grail of dealing with eyebags.
Well, the reality unfortunately is the anatomy and the fact that prolapse is forward as such
that beyond a certain level the hyaluronic acid, does not really help improve the appearance
of the bags.
And I know this first hand because in our practice, we see patients pretty much every
week who have gone to a non-surgical doctors who injected all this filler underneath and
made them look like they have even more bigger bags and that's the unfortunate additive effect.
You see fillers help to fill out depressions but when it is mounted on adjacent area of
fat prolapse, then you have to use a whole lot of fillers to try make that look like
one straight forward layer.
And do this for yourself.
Take a side view picture and notice the roundness and the bulge of that fat and realize that
the contour of an eyelid does not have a fatty bulge and is relatively straight or even concave.
So by adding volume at that level, I think you would probably not get the benefit what
you're looking for.
For People like yourself who are not concerned of eyelid surgery, I've been able to, over
the 20 years of practice, help people get passed that by dealing with some of the most
significant concerns.
One is, of course, is anesthesia.
So we do our procedures under local anaesthesia and as far as for men in particular, most
of my procedures, we don't make any incision on the outside.
A lot of men have been really concerned about the potential for a scar and that would be
obvious.
You know, women can typically wear makeup and blend the scar but for men that's usually
not an option.
So what we do for most of our male patients is we do procedure Transconjunctival Blepharoplasty.
Transconjunctival Blepharoplasty means reducing the fat pockets from the inside of the eyelid.
This way, there is no external scar.
We also do other procedures to help improve skin quality, skin texture and even color
such as the use of plasma and the use of fractional Co2 laser or radio frequency technologies.
But essentially, we have to address the puffy bags first.
Doing it under local anesthesia with light sedation also reduces the down time.
We are able make most of our patients look pretty good by 1 week.
So once alot of people who are hesitant of surgery learn this, they realize that if they
went for an injectable or a filler, they still have to deal with the potential swelling and
bruising so it's kind of like the same social risk us as having the surgery .
So by doing surgery, we kind of have a definitive procedure to address the fatty pockets but
that doesn't mean that you won't need anything for your tear trough.
Well that's subjective.
If you feel after the puffiness is reduced that the tear trough area is still deep and
that's normal.
Once you get to the age of 30 -- 35, there is a volumetric loss of the face where you
lose bone, muscle and fat and the area between the eyelid and the cheek is an area that tends
to hollow.
Adding volume can be a strategy.
I can share with you that for most of our male patients, that option is not usually
exercised.
Most male patients feel that like body builders, there is a certain level of leanness that
is normal and fine.
So it is okay but for a lot of female patients, they have a little bit fullness in the cheeks.
So practically speaking, you should find a doctor to help you with your lower lid puffiness
rather than chasing the expensive.
I hope that was helpful and I wish you the best
of luck.
Thank you for your question.