The tear trough and cheeks are often an area that are treated hand in hand and can, in the right cases, give a wonderful outcome leading to a refreshed look.
We have already discussed the treatment of the mid-face, and the importance of the use of dermal fillers, in a previous article and for those of you who have not had a chance to read this article you do so here.
I have used a case of a lovely patient to help you understand what the tear trough is and provide an appreciation of the effect of treating it in conjunction with the cheeks.
This particular patient, was concerned about the under eye region. She was keen for a rejuvenation in this region as she felt it gave her the appearance that she felt tired and that this was a particular region of her face which she felt had changed the most over the years.
To start with it is worth just mentioning a little bit of the anatomy in this region and the changes that can occur with time. I am a big believer of making sure you understand why these changes occur so that you can appreciate the reason for the treatment approach.
The tear trough (green) is the groove that runs from side of the eye that the tear duct is (i.e. corner of the eye closest to the nose) and this runs downwards. As the groove runs around the eye away from the nose, this is palpebromalar groove (orange) and there is also a groove that can run down the cheek called the mid-cheek groove or naso-jugal groove (brown).
These grooves tend to worsen with age. The tear trough and palpebromalar grove tends to be caused by fat loss in this region leading to deflation and also the differences in the skin under the eye and the cheeks. The naso-jugal groove is caused by a facial ligament (which is like a band that holds your skin to the bone. We have a number of these to stop our skin from flopping down!). The effects of the ligament becomes more apparent over time leading to a more pronounced groove.
These three grooves under the eye and on the cheek is what we can, if appropriate, attempt to address with dermal fillers. This is what we did with this particular patient in addition to placing some fillers over the cheek bone to help provide some cheek bone definition.
As you can see there has been a soft rejuvenation under the eyes and in the cheek region. We used a total of 2ml of fillers to achieve this bearing in mind that the type of filler used under the eye is very different to what can be used in the cheek.
I hope this helps explain how dermal fillers can be used under the eyes and the cheeks to provide a rejuvenated, less "tired" appearance. As ever, if you have any further questions please do not hesitate to contact us as we would be more than happy to help!