Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Filler vs Lift for the Orbit / Cheek Tear Trough Volume Loss

Q.  I’m looking at getting fillers or surgery for my loss of volume under my eyes. Which would be best?  I’ve been researching the doctors on RealSelf for quite a while now. Thank you all for your tremendous knowledge and input. I believe that underneath my eyes, the periorbital junction between my upper cheek and my lower eyelid is too deep. I’m thinking of getting fillers (Restylane?) first and then if I like that, I might consider surgery. But I am afraid that the area is too deep for success of either one. Am I a good candidate for either filler and/or blepharoplasty? By the way, I am 58 years old.

A.  Thanks for sharing your photo. While this is not an in-person consultation, it is helpful. You look great for your age and I agree with your concerns regarding descent  and hollowing of the naso-jugal fold / tear trough, cheek and jowl. Your options include:

  1. ​Fillers, 
  2. Implants, 
  3. Mid-face Lift / Silhouette InstaLift

While fillers maybe a first option for you, the thinness of the tissues are not kind to camouflaging the effects of current HA fillers; ie., visibility of a nodule or tubule-like form under the skin. Should you go this route, consider deep cheek injection with Restylane Defyne as it smoothens a bit better. 

Implants have their place and should be discussed as an alternative.

With descent of the cheek forming the jowls, a mid-face lift maybe the right choice when you are ready. This technique, well performed in the properly selected person will correct all these concerns. 

Consultation with a well experienced and skilled Board Certified Plastic Surgeon is necessary to provide proper examination, diagnosis of your concerns and effective treatment. 


Read more about similar topics:

Cheek Fill

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

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