At Harley Street Face Clinic, many patients come to us with a shadow or depression that appears beneath the lower eyelid, this is often termed the tear trough.
This appearance can give a tired appearance, and patients often find people comment that they look tired or stressed. The reason for these changes is often related to genetics and sometimes lifestyle (e.g. smoking).
The junction between our lower eyelids and upper cheek is referred to as the tear trough area. Tear trough hollowing is one of the earliest aging changes and often is a common feature from childhood. As we get older, this area alters in appearance, by becoming more hollowed, darker, deeper and less revitalised. In some people depressions can develop can make the eyes look somewhat sunken and create unattractive dark shadows, giving the appearance of tiredness, exhaustion and old age.
Rejuvenate natural loss of volume & increased beautification of your face
Longer-acting HA-fillers. Using the Phi Golden Ratio to give natural-looking results
Gold standard FDA-approved fillers, using 'no-needle cannula
technique' with facial specialist expertise
Lasts around 12-months (although exact duration varies from person-to-person)
Quantity dependent. Average quantity 1-2 vials of filler
Special topical anaesthesia using the cannula technique. Moderate discomfort
Mild redness, swelling (1-5 days), occasional bruising
Most patients back normal activity the next day
Fillers to chin & lips, skin rejuvenation
We offer long-term surgical enhancement (lower blepharoplasty)
There are essentially two ways in which this can be improved
Filler treatment is a popular solution for early treatment of these changes to the tear trough. The treatment involves carefully injecting a gel-like substance into specific areas around the eyes, with the objective of softening deep wrinkles and lines. Filler treatment to the lower eyelid is a more challenging technique and many non-specialist clinicians do not offer this treatment as it is more challenging than other parts of the face.
Filler can also be combined with other treatments including wrinkle injection, as well as skin resurfacing and other facial rejuvenation techniques to provide a ‘liquid facelift’ or facial rejuvenation.
We use several different fillers for various areas of the face, each specialised for a particular anatomical area. There is a wide array of different filler preparations that are currently available on the market and at your consultation, we will advise you on which will provide the best aesthetic solution for you.
The treatment can result in bruising and swelling. This technique is important in reducing recovery time. We have developed a customised a state-of-the-art no-needle technique, this focuses on the use of a blunt cannula to provide the treatment, this minimises bruising and swelling to less than 5% of patients.
You can expect to see relatively ‘instant results’ with our filler treatments. There will be minor swelling after the treatment, but for most patients that will resolve overnighT. More rarely there can be mild swelling for 5-days (in approximately 5%). There is a small possibility, <2% of a minor bruise, this will resolve over a few days. We use the latest technology to enhance recovery such as ‘no-needle” cannula techniques that enhance recovery. For most patients, the final results of cheek fillers will be evident approximately 5-days after the swelling subsides. With our techniques (application of filler at deeper levels) and filler choice will last 18 – 24 months, although results may vary from patient to patient.
Patient 1: “Tear trough filler can be completed to reduce hollowing and a shadow beneath the eyelid in younger patients with mild to moderate changes. Technqiue is important as with our use of a No-Needle Cannula technique, this speeds up recovery as 95% of patients have no bruising.”
Here at The Harley Street Face Clinic, we only specialise in natural-looking results. We believe in a natural augmentation of the lip area. Our aestheticians have pioneered research in the area of facial beauty and this has been published in the mainstream media and have been featured on multiple TV channels. We have also developed the application of the Phi Golden Ratio (used in many of the most famous Renaissance paintings of Leonardo Da Vinci) to the human face and we have multiple trained specialists that apply the principles of this facial balance and beautification technique. At The Centre, we have treated many celebrities and A-listers with these techniques to enhance natural beauty, a term we describe as beautification of the face, enhancing the natural Phi Golden Ratio Lines. Of key importance with filler, rejuvenation is avoiding excessive filler use as this no longer looks natural or beautiful. Key application of filler in specific areas of the face differs depending on each individual’s facial characteristics. The application of eyelid filler is different in masculine and feminine faces. In women, it is focused along the Phi Golden Ratio lines of the eyes, in men, it focuses along the lines of the chin and jawline. If you have already had a treatment that has been excessive it may be necessary to dissolve the existing filler or wait for the filler to resolve.
We use a combination of treatments to minimise discomfort, these include the use of a powerful numbing local anaesthetic cream that is specially made for The Centre. We use a state-of-the-art Cannula (no needle) technique to minimise discomfort. We use fillers that have incorporated anaesthetic into the injectable fillers to increase patient comfort. At The Centre, we use additional numbing and vibration devises that use the Nobel Prize winning research on ‘The Gate Control Theory of Pain” to minimise discomfort. At The Centre, we take the above measures to ensure most patients only experience minor discomfort.
Studies on safety of fillers have reported filler treatments as relatively safe with few side effects when completed by trained specialists. Recorded adverse events are usually minor including temporary injection site redness for less than three days. Patients may occasionally report temporary symptoms of redness, swelling, discomfort, lumps-bumpy changes, bruising, itching or change in colour. Infection is very rare however it is important that the treatment is completed in a CQC registered site (Care Quality Commission) and sterile precautions when having filler treatments. At The Centre all treatments are completed in our specialist Facial Centre on Harley Street. Serious side effects such as damage to skin (termed Necrosis) or damage to vision have very rarely been reported. Our staff have pioneered the teaching of other doctors to avoid these serious issues in both National and International Conferences since 2012. Fillers are currently lacking from regulation, which remains a controversy in the UK. Precautions can be taken with competent practitioners to avoid these serious complications.
Patient 1: “A hyaluronic acid filler can be effectively used to rejuvenate the lower eyelid area. Care is required to use a filler with non-absorbable qualities (termed ‘Hydrophilic”) this is key to avoiding swelling after treatment”
We use a combination of treatments to focus on a natural rejuvenation that is both safe, long lasting and safe. Over the last 5-years fillers have become more and more popular as both the product has reached new levels of quality and safety and our techniques and skills at using them have matured with experience, Our team have been using non-surgical treatments for patients for over ten years. We believe that it is important to avoid potential issues, we believe that there are certain products that are associated with higher risk issues, including permanent and semi-permanent fillers.In some patients this can result in long-term issues.
The lower eyelid is an intricate area of the face, and certain fillers should be avoided as they have properties that may result in increased swelling as well as lumpy-bumpiness all of which can be avoided. At The Centre we specialist in the face with knowledge of these fillers that are best avoided (including Juvaderm).
Some patients may have facial anatomy which is characterised by marked changes of their lower eyelids and these patients are better suited to a surgical correction including the use of lower blepharoplasty with fat transfer.