Tear trough filler in London

The treatment of lower lid ageing

What are tear trough fillers?

Tear trough filler is a popular treatment that aims to correct the tired appearance of tired looking eyes with the use of undereye filler. It works to replace the volume that is lost around the lower eyelid that develops with the ageing process.

It can be used not just in this area but throughout the face in areas such as the lips, cheeks, nasolabial folds, the marionette lines around the mouth, the cheeks and the brows. It can also be placed in combination with botulinum toxin injections to give a more rejuvenated appearance.

Should I have tear trough filler treatment?

The treatment is a good option for patients who have hollowing in the under eye area or eye bags. Some people complain fo having dark circles in the under eye area from the hollowing which can give a look of being tired even when you are not.

Filler injections can help replace lost volume in this area that happens with ageing and restore the colours of the face and in the nasojugal groove that is a line on the face that extends across the cheek in some cases. In many people they help avoid the need for plastic surgery.

If the eye bags are more extensive a surgical procedure like a blepharoplasty may be more appropriate.

What is the best age for under-eye fillers?

Tear trough filler treatment is increasing in popularity amongst younger people and the ideal candidate is not based on aged but more on having a tear trough deformity that requires treatment to create a more youthful appearance.

What is the tear trough and how does it change with age?

This is the junction between the lower lid and the upper cheek and includes the nasojugal groove which is a diagonal line the separates these two area and becomes more visible with age and the volume loss that occurs.

How do I prepare for the treatment?

At the intial consultation with Mr Ahmad Aziz at his London clinic you will go through your medical history and have an assessment of your eyes ad the facial area. Your expectations of treatment will be explored and advice will be given on what can be reasonably achieved along with the risks and benefits of tear trough injection. If filler injection is deemed suitable for your case the treatment can be done. In preparation for treatment it is recommended that you avoid alcohol for 24 hours before the appointment, aspirin, ibuprofen and vitamin E should be avoided for 1 week before to the appointment to minimise the mild bruising that can occur.

How is the treatment carried out?

This is a non-surgical treatment of injectable filler placed into the tear trough area. Numbing cream may be applied so that this injection is not felt. Hyaluronic acid filler is used which can be dissolved if needed. It is used in combination with a local anaesthetic to make it more comfortable.A sharp needle is used which is very fine and blood vessels in the area are avoided to minimise the bruising. The product is placed in areas to replace the volume lost and also works to boost the collagen in the skin that is lost with ageing. If also hydrates the skin giving a softer appearance.

The procedure takes about half an hour to do and can be combined with treatment to other areas of the face. Eye filler on its own may be sufficient in some people but in others the cheek area also has a loss of volume and dermal filler to this area may also be applied. The product can also be used in combination with botulinum toxin.

When will the results be visible?

The results tend to be instant and the aim is for a natural appearance. The final results tend to take around two weeks to take full effect as the product merges with the surrounding tissue and the skin smooths over the area to give the final result.

Do the results look natural?

The aim is always for a natural looking result. There will not be a dramatic change following the treatment as this is not the intention. The treatment is used to give an improved look and those with a very deep tear trough may not be suitable. The goal is for a subtle effect that softens the area with a natural looking result.

Is it painful to have tear trough fillers?

They can be uncomfortable but with the use of numbing cream the discomfort is reduced. Many people find the procedure a lot more comfortable than what they were expecting.

What happens during the recovery period?

There is usually a rapid recovery following the injection and the results are instant in many people. You are able to go one with your regular activities after the treatment and many people go back to work on the same da. There can be some swelling and bruising present that settles in a few days. To minimise any swelling it is recommended to use cold compresses to the injected area regularly. Arnica cream can be applied a bedtime to work to reduce the swelling overnight. The area should not be touched or make up applied to the area on the day of the treatment. It can be washed gently with soapy water. Avoiding alcohol and vigorous exercise is advised for 2 days after the injections and saunas and sunbeams should be avoided for 2 weeks to minimise any extreme heat to the area.

How long do fillers under the eye last?

The products used tend to be long lasting but not permanent . They will slowly break down with time. Individual results vary but most people my require reset treatments every to 2 years although some people can have a treatment that lasts for many years. Poor diet and smoking can have an impact on how long the treatment lasts and tend to make the product break down quicker.

Can the upper eyelid be treated?

They cn be used in the upper eyelid if there is upper eyelid hollowing and a deep upper eyelid sulcus.It is not advised to see a general cosmetic surgeon. Filler application to this area is specialised and requires an oculoplastic or facial plastic surgeon like Mr Ahmad Aziz who is familiar with this area. They are more familiar with the anatomy or the orbicularis oculi muscle and the orbital rim and how best to place the product.

What type of filler is used?

A hyaluronic acid filler is used. There are different manufacturers and types and the brand and type used depends on the treatment required and the facial anatomy. Juvederm ultra is a popular brand used in this area but other products may be more suitable is a more superficial application is required to minimise any potential Tyndall effect. If you have had an adverse reaction to a type of filler previously then this would not be used and a different brand would be required. Only products that can be dissolved and have a proven safety record are used.

Are tear trough filler safe?

This is a safe procedure if carried out by someone who is highly skilled in this area and done in a clean and safe environment. The products used are dissolvable and can be quickly dissolved in the rare cases of complications developing. It is important to ensure that the procedure is carried out by someone who is specialised in this area.

Are there any risks or complications?

Any treatment does have potential complications and the most common are bruising and swelling which settle with time. A small number of people may not tolerate fillers and can develop irregularities and swelling which would require further treatment. Rarely some cases can develop a discolouration to the area known as a Tyndall effect but fortunately some products can be used that have been shown to minimise this risk. The risks and complications will be explained prior to carrying out any potential treatment. These treatments are not recommended to those who are pregnant or those who have had a severe reaction in the past.

Can any other procedures be done at the same time?

In addition to eye fillers, it can be used to other areas of the face. Botulinum toxin or botox injections can be used depending on the area that develops wrinkles on the face. If other treatments are desired then these can be discussed at the consultation to see if you are suitable for them. Placement of product is commonly done not just around the eye but also the temple, cheek and brow to create a softer and more youthful look to the upper face.

What are the treatment options for complications?

Mr Ahmad Aziz is referred patients who have had complications with fillers. Complications can happen when the wrong type of product is injected or it is placed in the wrong area. If too much product is applied this can also give an unnatural look and make any eye bags or eye circles worse. Some are more likely to result in long term swelling and granulomas which can give a lumpiness and discomfort to the skin.

The side effects of dissolving injections applied to the wrong area can dissolve the skin’s natural hyaluronic acid resulting in damage to the skin structure. Treatment options include hyalruonidase, antibiotics, steroids and on occasion surgery.