What is it?

The normal aging process causes a weakening of the periocular tissues, causing them to become lax and saggy. The loss of skin tone allows orbital fat to move forward, mainly in the lower eyelids, causing them to bulge and swell. Also, fluid can build up in that area, making it appear edematous (swollen).

In addition to aging there are some factors that can predispose and / or cause tear trough deformity, such as lack of sleep, smoking, fluid retention problems, and a certain family predisposition.

Among the tear trough deformity, we must mention the periorbital facial lipoatrophy. This is a physiological process of reabsorption of supra periosteal fat (the one that is on top of the bone) and subcutaneous that evolves with age (we would speak of “sunken eyes”). Factors such as sex, as well as a certain genetic predisposition, influence its genesis. This process, together with the loss of bone volume, laxity of the retention ligaments, and other structural changes at the level of deep and superficial periorbital fat compartments, determine a characteristic pattern of aging in this area.

Tear trough deformity, in most cases, an aesthetic problem.

In addition to the bags, preferably in younger people, some shadows may appear under the eyes (the eyelids take on a purple color). It is very important not to confuse tear trough deformity with shadows under the eyes (dark circles). Although these shadows can be a consequence of aging, they are not the same as tear trough deformity.

Types of Tear trough

Tear trough deformity can be classified according to volume and periorbital fat. Thus, we have tear trough deformity with insufficient volume without ptosis; insufficient volume with ptosis; normal volume without ptosis; normal volume with ptosis; excess volume without ptosis; and excess volume with ptosis.

Can Tear trough be prevented?

There are some home remedies to prevent the onset of bags under the eyes, and even reduce their volume. The use of cold compresses, acquiring healthy habits (sleeping the necessary hours, sleeping with the head slightly raised, quitting the smoking habit), reducing the intake of salt, or avoiding drinking liquids before sleeping can prevent the onset of bags under the eyes. The use of cosmetics does not eliminate, but reduces its aesthetic impact (mainly in lipoatrophy).

Symptoms

Tear trough deformity is primarily a cosmetic problem and is not associated with specific symptoms. The presence of pruritus (itching) and / or pain in the area, with or without redness, are reason to consult your ophthalmologist.

Treatment

Tear trough deformity, from an aesthetic point of view, need a comprehensive approach. That is, taking into account both the laxity of the skin and the potential tissue defect (if any).

In younger people, the affectation is limited to the area of the tear trough, while, in older people, the problem extends to the entire periorbital region. The therapeutic approach must be adapted to the needs and characteristics of the patient.

From an aesthetic point of view, the treatment may be focused on correcting the volume defects that affect the area of the tear trough deformity itself or on performing a comprehensive treatment that includes the entire periorbital region.
The use of hyaluronic acid dermal fillers has provided good aesthetic results with a good safety profile. However, its use is not without risks. You should consult your specialist about the possibility of performing these treatments and their possible adverse effects.

Other minimally invasive strategies for treating tear trough deformity include laser skin surface resurfacing or chemical peels.

The surgical technique of choice for patients with eye bags is blepharoplasty. It is an outpatient procedure that is performed under local anesthesia, in which the ophthalmologist makes an incision under the eyelashes or inside the lower eyelid. The surgeon removes excess fat through the incision and sometimes removes excess skin, then closes the incisions with small stitches.

In addition to correcting bags under the eyes, blepharoplasty can also repair puffy or puffy upper eyelids.

Blepharoplasty is a safe technique, but it is not without risks.

Prognosis

Due to its location (different vascular bundles pass through this region) and its structural characteristics (thin skin), the periorbital region represents one of the most complex areas to treat in aesthetic medicine. A thorough knowledge of the anatomy of the region is essential in order to obtain optimal aesthetic results.

Before considering a treatment in this area, consult your ophthalmologist.