Lower eyelid – Cheek junction
Have you ever said to yourself, “why do my eyes look tired”?, this could be related to your lower eyelid area. This is what is known as the “lid-cheek” junction, or sometimes it is called the tear trough. As we age, two things happen in this area.
- Bulging of the lower eyelid fat. This will be most noticeable in overhead lighting and when you gaze upward. There are 3 fat pockets that may need to be dealt with surgically.
- Loss and descent of the fat in the cheek. This will make the bulging lower eyelid fat look even more apparent.
The other factor is related your own tear trough anatomy. Some people have more prominent and distinct ligaments in the tear trough that create a “valley”. How severe it is depends on your age and your own individual anatomy. It can be present in very young patients, even children. It is classified as below.
Two peaks and a valley… much like our beloved “Valley Isle”
How do I fix tear trough deformity?
In younger patients all that is needed is perhaps a small amount of hyaluronic acid filler. The result will last approximately a year. It is also possible to use your own fat that is harvested from your abdomen and use it to fill the tear trough “valley”.
In this patient, hyaluronic acid filler was injected into the tear trough in order to smooth the lid-cheek junction. Hyaluronic acid filler commonly goes by the brand names of Juvederm, Restylane, Revanesse Versa. There are many varieties of varying thickness that can be used for this purpose. Recovery for this procedure is approximately 1 week of minor swelling and bruising.
Lower Lid Surgery (Blepharoplasty)
In someone with more severe deformity, removing the lower eyelid fat or repositioning it to the deficient area may be required. If there is an excess of skin, this may be removed through a small incision that heals very well in most patients. This is a procedure that can be done in my office OR under local anesthesia. Recovery for this procedure is approximately 1-2 weeks.
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