In the world of aesthetic treatments, fillers have become a popular choice for reducing under-eye hollows and creating a refreshed appearance. However, as an oculofacial plastic surgeon with experience in addressing delicate areas around the eyes, I've seen that fillers, particularly in the tear trough region where the skin is exceptionally thin, can lead to complications over time. As I’ll explain below, dissolving these under eye fillers prior to eyelid surgery (blepharoplasty) can significantly enhance both safety and results.
Common Issues with Fillers in the Tear Trough Area
While fillers are often used to smooth under-eye hollows, they come with inherent risks in this sensitive area. These issues are not a question of "if" but "when," as the tear trough is uniquely prone to problems such as:
Swelling: Fillers, especially those with hyaluronic acid, attract water and can cause ongoing puffiness that worsens with time or following surgery.
Discoloration: Fillers under thin eyelid skin can lead to discoloration or a bluish hue (Tyndall effect), giving an unnatural appearance.
Lumps and Irregularities: The delicate under-eye tissue can struggle to hold filler smoothly, often leading to lumps or uneven contours that disrupt the natural eyelid shape.
Fillers vs. Surgery: A Long-Term Approach to Under-Eye Hollows
For these reasons, I prefer lower eyelid blepharoplasty with fat repositioning over filler injections in the tear trough. A surgical approach often yields a more refined, natural outcome that aligns with the eye's natural anatomy and avoids filler-related risks. Additionally, while fillers require periodic upkeep, a well-performed blepharoplasty offers long-lasting results, making it a more cost-effective solution over time.
Fillers and Swelling: How Dissolving Fillers Can Improve Surgical Outcomes
Hyaluronic acid fillers are hydrophilic, meaning they naturally attract water like a sponge. This can pose issues during eyelid surgery and the post-surgery recovery phase:
Prolonged Swelling: The body’s response to surgery includes some degree of fluid retention or edema. Fillers under the eyes will absorb this excess fluid, leading to more swelling and a longer recovery period.
Impaired Surgical Precision: Fillers can distort the natural anatomical planes of the lower eyelid, making it more challenging for a surgeon to work with the existing tissue. Dissolving fillers allows for a clear, unobstructed view of the tissue, enabling a more precise and controlled procedure.
For those considering blepharoplasty, dissolving any existing fillers well in advance allows the tissue to "settle" back to its natural state, ensuring that the surgery can be as effective and seamless as possible.
Setting Up for Success: Dissolving Fillers for Optimal Aesthetic Outcomes
In my experience, starting with a clean slate—meaning no fillers under the eyes—leads to a smoother recovery and optimizes aesthetic outcomes. If you’re contemplating eyelid surgery and have previously had fillers in the tear trough area, dissolving them beforehand can make a meaningful difference. This extra step helps reduce complications, improves healing, and maximizes the potential for achieving beautifully natural, long-lasting results.
If you have questions about eyelid surgery, fillers, or the benefits of a filler-free blepharoplasty, feel free to reach out. Together, we can create a treatment plan that prioritizes safety, precision, and aesthetic harmony.
Dr. Abboud is an oculofacial plastic surgeon in San Diego who is an expert on cosmetic eyelid surgery. He is board-certified by the American Board of Ophthalmology (ABO) and is a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).
For more information about lower eyelid rejuvenation, or to schedule a consultation with Dr. Abboud for personalized advice on eyelid rejuvenation, call our office at 858.356.2647
These are images of actual patients of Dr. Jean-Paul Abboud. They are shown for informational purposes only and are provided with written patient consent for use on this website. Please do not copy or distribute images/videos. Each individual’s treatment and/or results will vary, and no guarantee is stated or implied by any photo or statement used on this website.
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