Patient information Tear trough fillers / Tear Trough rejuvenation

You can also read one patient's diary of her treatment in this Patient experience.

Mr Malhotra conducting a live teaching workshop for German cosmetic doctors at the Q-MED (makers of Restylane) Aesthetic "Training-the-trainers" seminar, Frankfurt, Germany – February 2011

Operations to remove under-eye bags have been common for years. Many people, however, have the opposite problem. As they age, they develop trough-like hollows where the top of the cheekbone meets the under-eye. These are known as tear troughs.

The cause is a loss of facial volume and tissue elasticity — in the cheek area as well as under the eye — along with a mild reduction in bone volume and a general descent of skin.

These not only combine to create tear troughs. They also accentuate dark circles under the eyes, making people look tired and worried, even when they're well-rested and happy.

Surgery, usually in the form of a lower eyelid lift (blepharoplasty), is not always appropriate to correct tear trough shadowing, although people with very loose skin or pronounced eye-bags will benefit.

"Mr Malhotra, you have saved me a fortune in concealers!"

Procedure

Tear trough filling is an outpatient procedure that offers a minimally-invasive, non-surgical alternative, with a reduced risk of any complications and minimal recovery time.

Mr Malhotra has developed the use of Restylane Perlane, a clear gel filler that has been used for many years in other areas of the face. It is made of hyaluronic acid, which is present in all living organisms. It creates volume and is hydrating. Since the hyaluronic acid in Restylane is not made from animals, there is no risk of transmitting diseases from animals or triggering allergic reactions in patients who are sensitive to common foods, such as beef, chicken and eggs.

The treatment comprises a series of micro-injections along the line of the hollow. The area is then gently massaged to ensure even distribution of the gel. The results are instant and last between six and 12 months.

"My husband is so delighted and reassured about the procedure. The results are all I hoped for — I will certainly be back."

" The treatment was quick and is best described as mild discomfort. I was so excited to see the hollows literally disappear before my eyes! Everyone has commented on how well I look, that I look somehow better without being able to pinpoint why. This is precisely the reaction I wanted!"

What to expect

There may be some discomfort during treatment, either when the injection takes place or during the massage that ensures a smooth contour, although many patients find it relatively pain-free.
Occasional contour irregularities can occur but, once any swelling has subsided, you can massage any tiny lumps with your thumb or index finger to flatten out any unevenness.
If you are unhappy with the result, the filler can be easily and rapidly dissolved with an injection of hyaluronidase.
There may be some bruising and/or mild swelling but these normally disappear in around a week.

"The results are absolutely fantastic now the bruising has gone. I'm totally thrilled. Look forward to seeing you in the future."

All procedures begin with a consultation. For full information about what to do before and after surgery, see Patient information.

You can also read one patient's diary of her treatment in this Patient experience.

Below are photographs of treatments carried out by Mr Malhotra:

Before tear trough fillers example 1