You have tried everything to make your dark circles disappear, yet your face looks as hollow, sunken and tired as before. Your dark circles may be due to a not so obvious, often ignored, but easily treatable root cause- Tear Trough Deformity!
In this blog, we help you understand the background of this condition and how it can be treated by an oculoplastic surgeon.
What is tear-trough deformity?
It is nothing but the depression that runs from the inner corner of the eyelid that runs along the infraorbital rim to the outermost corner of each eye. A significant tear trough deformity presents itself by a sunken appearance of the area around the eye, casting a dark shadow over the lower eyelid giving an exhausted appearance despite sufficient rest.
R.S. Flower first coined the term in 1993. It can be present from birth or due to the ongoing ageing process.
How is tear-trough deformity formed?
The anatomy and understanding of tear-trough deformity are complex topics in medical aesthetics. That being said, medically speaking, there are three identified reasons for a tear trough deformity:
- a teardrop-shaped depression formed due to the separation of the muscle (orbicularis oculi), which circularly runs around our eyelids and is responsible for opening and closing our eyelids,
- a flatter cheekbone,
- a strong ligament structure that connects the skin of the middle part of the corner of the eye to the underlying bone
Are there different levels of tear-trough deformity?
Depending on the dynamics of the three reasons mentioned above, different levels of tear-trough deformity are created, which can be classified as:
- Grade 1 or mild (just near the corner of the eye)
- Grade 2 or moderate (extends to the middle part of the cornea)
- Grade 3 or advanced (extends to the central part of the cheek)
So what does tear-trough deformity do?
It creates a sunken, hollow, sad, tired, depressed look on the face. It also increases the appearance of dark circles because a shadowing effect is created when the depression is present, which increases the amount of darkness around the eyes and eyelids.
How is tear trough deformity treated?
The primary treatment is to fill this defect with dermal fillers such as hyaluronic acid fillers. The area around the eyes is one of the most complex areas in our body to be injected; this treatment has to be done by an advanced injector. Results are good.
Our expert Dr Shubhra Goel prefers Juvaderm Ultra CX or Restylane Classic. She injects small amounts along the bone and then layers it below the skin (sub-dermal level).
Additionally, the treatment approach changes if any fat prolapse is present, creating a valley-hill effect (valley is the depression of the tear trough, and the hill is the fat prolapse that makes eyebags). Depending on the extent of eyebags, a surgery called blepharoplasty is undertaken to remove the fat. Sometimes, the fast is also re-draped into the depression, creating an overall balanced effect.
Finally, our expert uses Profhilo- a hydrating skin filler that helps plump the thin, wrinkled skin around the eyes. Using Profhilo allows the eye area to look rejuvenated, removing the hollowness.
Is it safe to treat tear-trough deformity?
Absolutely. When the treatment is undertaken by a trained specialist like an oculoplastic surgeon specifically trained to treat this delicate part of the face, the treatment is safe, predictable, and gives good results.
Co-founded by Dr Shubhra Goel, a prominent, multiple award-winning, dually certified oculoplastic surgeon with decades of experience worldwide, Clinica Fai (www.clinicafai.com) is a super-specialist medical clinic that provides eye and face corrective treatments with particular focus on correction of dark circles, baggy/puffy eyelids & previous treatments gone wrong. Dr Shubhra Goel has been trained under celebrity oculofacial plastic surgeon Dr Cynthia Boxrud from LA and superstar dermatologist Dr Zein Obagi from Beverly Hills.