How Much Filler Is Used In Tear Trough

Consult Dr. Laura Geige for Dermal Fillers at It’s Me and You Clinic

Tear Trough Anatomy

Subdermal Fat Depots

Tear troughs are the concave depressions located beneath the eyes, extending from the inner corner to the outer corner.

They are formed by the interplay of several anatomical structures, primarily *subdermal fat deposits*, *underlying orbital bone*, and *skin thickness*.

Understanding these elements is crucial when assessing tear trough volume loss and determining appropriate filler volumes for rejuvenation.

**Subdermal Fat Depots:** These fat pads act as natural cushions and contribute to facial contouring.

The *tear trough region* typically has two key subdermal fat depots:

* The **medial tear trough fat pad:** Situated closer to the inner corner of the eye, this pad is often prominent in younger individuals, contributing to a youthful appearance.

* The **lateral tear trough fat pad:** Located further outward, it contributes to the overall contour of the lower eyelid and cheek area.

With aging, these fat pads can atrophy (shrink), migrate downward, or both, leading to hollowing of the tear trough.

**Orbital Bone Structure:**

The shape and prominence of the *orbital bone* (the bony structure surrounding the eye) play a role in defining the tear trough. A more prominent orbital bone can accentuate tear trough depth, even with adequate subdermal fat.

**Skin Thickness:**

The thinness of skin overlying the tear trough contributes to its visibility. As we age, skin naturally loses elasticity and collagen, becoming thinner and making underlying structures more prominent, including any hollowness in the tear trough.

The Orbicularis Oculi Muscle

The tear trough is a subtle depression located below the inner corner of the eye, extending towards the middle of the cheekbone.

It’s created by the confluence of several anatomical structures, including skin, subcutaneous fat, the orbital bone, and underlying muscle.

This region is often susceptible to aging changes, leading to deepening of the tear trough and prominence of under-eye hollows.

Contributing factors include volume loss in the cheek and orbital fat pads, thinning of the skin, and weakening of supporting structures like the orbicularis oculi muscle.

The orbicularis oculi muscle is a ring-shaped muscle surrounding the eye. It plays a crucial role in eyelid closure, blinking, squinting, and other facial expressions.

This complex muscle comprises two main parts: the orbital portion, responsible for eyelid closure, and the palpebral portion, which contributes to fine movements of the eyelids.

In relation to the tear trough, the orbicularis oculi muscle’s action can impact volume distribution in the area.

When it contracts, especially during forceful blinking or squinting, it can compress the underlying fat and contribute to a temporary deepening of the tear trough.

Conversely, as we age, weakening of the orbicularis oculi can lead to sagging and laxity around the eye, potentially accentuating the appearance of under-eye hollows.

Arrange a Dermal Filler Appointment with Dr. Laura Geige

Skin Thinning and Laxity

The tear trough is a delicate area under the eyes that can show signs of aging as we get older. This prominence is caused by several factors, including bone resorption, loss of fat volume, and thinning of the skin.

Skin Thinning:

The skin in this region is naturally thinner than other areas on the face. As we age, collagen and elastin production declines, leading to further thinning and laxity.

Loss of Fat Volume:

Over time, the fat pads that support the lower eyelid can shrink, causing a hollow appearance in the tear trough area. This volume loss contributes significantly to the development of dark circles and pronounced wrinkles.

Muscle Action:

The orbicularis oculi muscle, which surrounds the eye, plays a role in both blinking and facial expressions. As we age, repetitive muscle movement can lead to deepening of the tear trough.

Vascularity:

The tear trough area has a rich network of blood vessels. With thinning skin, these vessels become more visible, contributing to the appearance of dark circles.

Understanding the complex interplay of these factors is crucial for determining the appropriate treatment approach for tear troughs, including the amount of filler needed for optimal results.

Filler Options for Tear Troughs

Hyaluronic Acid Fillers

Tear trough fillers are a popular non-surgical cosmetic treatment aimed at addressing dark circles and hollowness under the eyes.

*Hyaluronic acid (HA)* is the most common type of filler used for tear troughs due to its ability to attract and retain water, plumping up the skin and reducing the appearance of hollows.

The amount of HA filler used in tear troughs varies depending on factors such as:

**Individual needs**: Severity of hollowness, thickness of existing skin, patient’s desired outcome.

**Filler type**: Different HA fillers have varying viscosities (thickness), which influences the amount needed to achieve desired results.

A skilled injector will assess these factors to determine the appropriate volume for each patient.

Generally, tear trough injections involve placing small amounts of filler strategically under the skin along the tear trough, aiming to create a smooth, gradual contour.

Excessive use of filler can result in a “puffy” or unnatural appearance. Therefore, conservative application and subtle enhancements are key to achieving natural-looking results.

It’s important to consult with a qualified and experienced injector for tear trough filler treatments. They will provide personalized recommendations based on your individual needs and goals.

Calcium Hydroxyapatite (CaHA)

Tear trough filler treatments aim to address under-eye hollows and create a more youthful appearance by restoring volume.

Calcium hydroxyapatite (CaHA) has emerged as a popular choice for tear trough rejuvenation due to its unique properties and safety profile.

Here’s a detailed look at CaHA fillers specifically for tear troughs:

Get Started with Dermal Fillers – Consult Dr. Laura Geige

**Benefits of CaHA in Tear Troughs:**

– **Natural-Looking Results:** CaHA fillers provide a subtle, gradual lift and smoothing effect, resulting in a more natural appearance compared to some hyaluronic acid (HA) fillers.

– **Biocompatibility:** CaHA is made from naturally occurring calcium salts found in bone and teeth, making it well-tolerated by the body.

– **Structural Support:** CaHA’s gel-like consistency provides robust structural support to the tear trough area. It helps lift sagging skin and fill in hollows effectively.

– **Longer Lasting Effects:** CaHA fillers tend to last longer than some HA fillers, with results often lasting up to 18-24 months or even longer.

– **Reduced Risk of Complications:** CaHA fillers have a lower risk of causing common side effects associated with HA fillers, such as swelling and bruising.

**Factors Affecting Filler Volume:**

The amount of CaHA filler needed for tear troughs varies depending on several factors:

• Severity of under-eye hollows: Deeper hollows will require more filler.

• Individual anatomy and skin thickness

• Desired outcome: Subtle smoothing versus a more pronounced lift.

A qualified aesthetic injector will carefully assess your needs during a consultation to determine the optimal volume of filler for your tear troughs.

Remember that it’s essential to choose an experienced and licensed injector who understands the delicate nature of the under-eye area. They can provide personalized guidance and ensure safe and effective results.

Considerations for Treatment

Patient Expectations and Goals

Treatment considerations for tear trough augmentation involve a delicate balance between achieving desired aesthetic results and ensuring patient safety and satisfaction.

A thorough evaluation should include assessing the patient’s anatomy, skin quality, volume loss severity, and underlying tear trough morphology.

Understanding the patient’s expectations and goals is crucial. Some may desire a subtle smoothing of the hollows, while others seek a more dramatic volumization effect.

Treatment planning should consider potential complications such as bruising, swelling, asymmetry, and vascular occlusion.

The choice of filler material depends on individual patient needs and aesthetic objectives. Hyaluronic acid fillers are commonly used due to their versatility, biocompatibility, and reversibility.

Precise injection techniques are essential to avoid overcorrection, irregularities, and migration of the filler.

Post-treatment care involves minimizing sun exposure, avoiding strenuous activity, and following the provider’s instructions for managing potential side effects.

Patients should be informed about the limitations of treatment, as tear trough correction is not permanent and touch-up treatments may be required over time.

Managing patient expectations realistically is key to ensuring a positive outcome.

Open communication throughout the process fosters trust and allows for adjustments to the treatment plan if needed.

Needle Size and Technique

Considerations for Treatment, Needle Size and Technique in tear trough filler injections are crucial for achieving natural-looking results and minimizing risks.

Treatment Considerations:

• Patient Assessment: A thorough evaluation should assess the patient’s individual needs, including tear trough depth, skin laxity, underlying bone structure, and desired outcome.
• Tear Trough Anatomy: Understanding the anatomy of the tear trough, including the location of major blood vessels and nerves, is essential for safe and effective injection.
• Volume Assessment: Determining the appropriate volume of filler to use is critical. Overfilling can lead to a unnatural “bump” appearance, while underfilling may not address the concerns adequately.

Needle Size:

• Fine Needles: 25-gauge or 30-gauge needles are typically preferred for tear trough injections due to their smaller diameter, which reduces trauma to the delicate skin.
• Short Needles: Shorter needles (typically 1/2 inch) minimize the risk of injecting filler too deeply.

Injection Technique:

1. Superficial Layer: Filler should be injected into the superficial layer of skin to create a subtle lifting effect.
2. Linear Placement:** Injecting in linear or fanning techniques helps distribute the filler evenly and achieve a natural look.
3. Multiple Layers: In some cases, multiple layers of filler may be necessary to address deeper depressions.

Important Considerations:

• Experienced Injector: It is essential to consult with an experienced and qualified injector who specializes in facial aesthetics.
• Patient Communication: Open communication between the patient and injector is crucial for understanding expectations, potential risks, and achieving desired results.
• Follow-up Care: Adhering to post-injection instructions and attending follow-up appointments are important for optimal healing and long-lasting results.

Potential Complications and Risks

When considering tear trough filler treatment, several factors influence the appropriate volume and type of filler used.

The depth and extent of the under-eye hollowing, as well as the patient’s individual facial anatomy, play a crucial role in determining the necessary amount of filler.

A thorough assessment by a qualified practitioner is essential to determine the optimal treatment plan.

Potential complications and risks associated with tear trough filler injections include:

**Vascular Occlusion:** Injecting filler too close to blood vessels can lead to blockage, potentially causing tissue ischemia or necrosis.

This risk is minimized by using cannulas instead of needles for injection, as well as meticulous technique.

**Swelling and Bruising:** These are common side effects that typically subside within a few days to a week.

Application of cold compresses and gentle massage can help reduce swelling.

**Tyndall Effect:** This refers to the visibility of blue or white filler particles under the skin, creating an unnatural appearance.

It can occur if the filler is injected too superficially or if it migrates upwards.

**Asymmetry:** Variations in filler placement can lead to noticeable asymmetry between the two sides of the face.

Careful injection technique and attention to detail are essential to minimize this risk.

**Lumps and Nodules:** Filler may sometimes clump or form nodules under the skin, which may require manual massage or additional treatment to resolve.

**Infection:** Any invasive procedure carries a risk of infection.

Practitioners must use sterile techniques to minimize this risk.

**Allergic Reaction:** Although rare, some individuals may experience an allergic reaction to filler components. It is important to disclose any known allergies to the practitioner beforehand.

It’s essential to consult with a qualified and experienced practitioner to discuss individual risks and benefits before undergoing tear trough filler treatment.

They can provide personalized guidance and address any concerns you may have.

Kurious Kittens C4YL Melissa J Design Madison Art Therapy