2nd March 2023

Choosing Between Tear Trough Filler and Blepharoplasty: Which is Right for You?

Last Modified: March 27, 2024

Under eye filler or blepharoplasty, which one do you choose? Let’s find out.

As we grow older, our skin undergoes several changes due to the natural ageing process and environmental factors such as sun exposure and pollution. One of the most significant changes is the loss of elasticity in the skin. The skin's ability to stretch and then recoil back to its original shape diminishes as we age. This is due to the decrease in the production of collagen and elastin, two proteins that help to keep the skin firm and supple.

Collagen is the most abundant protein in the body and is responsible for providing strength and structure to the skin. Elastin, on the other hand, allows the skin to stretch and then return to its original shape. However, as we age, the production of both collagen and elastin slows down, leading cause behind sagging and drooping skin.

This effect is particularly noticeable around the eyes, where the skin is thinner and more delicate. As the skin loses its ability to bounce back, it can create wrinkles, fine lines, and folds around the eyes.  If that wasn’t bad enough, the loss of fat under the eyes could make the skin appear even more wrinkled and saggy. That’s because fat plays a crucial role in providing support and structure to the skin.  It provides a cushioning effect that helps to keep the skin taut and smooth.

As we age, the fat pads beneath the eyes begin to shrink and migrate downward, creating hollows and depressions beneath the eyes. Without the support of fat, the skin around the eyes is less able to resist the effects of gravity and begins to sag and droop. This is also a major contributor to puffiness or bags under the eyes.

Tear Trough Filler and Blepharoplasty

How these changes can affect us?

These changes can contribute to a perpetually tired or stressed appearance, even if the individual is otherwise healthy and well-rested.  Additionally, under-eye wrinkles and folds can be particularly noticeable when smiling or laughing, leading some individuals to feel self-conscious about their appearance.

Fortunately, there are several cosmetic procedures available to help address under-eye wrinkles and folds, particularly under-eye filler and blepharoplasty. These treatments can help to restore a more youthful, refreshed appearance to the eye area by reducing sagging and drooping.

But which do you choose? First, let’s quickly go through the history of each.

The Brief History of Blepharoplasty

Blepharoplasty, or eyelid surgery, has a long history dating back to ancient times. The first documented blepharoplasty procedures were performed around 800 BC in India, where the surgeon Sushruta developed techniques for repairing damaged eyelids. In ancient Rome, the physician Celsus wrote about a surgical technique for removing excess eyelid skin.

However, modern blepharoplasty techniques didn't appear until the early 20th century. The first documented blepharoplasty was performed in Germany in 1907 by Dr Jacques Joseph. Joseph's technique involved making an incision in the natural crease of the upper eyelid and removing excess skin and fat.

Over the years, the technique evolved and became less invasive. In the 1950s and 1960s, surgeons began to use the transconjunctival approach. Blepharoplasty with a transconjunctival approach is a form of eyelid surgery used to correct the appearance of the lower eyelids.

During the procedure, the surgeon makes a small incision on the inside of the lower eyelid, called the conjunctiva, and removes or relocates the fat pads that cause the puffiness or bags under the eyes. Because the incisions are made on the inside of the eyelid, there are no visible scars on the outside of the eye. This means the recovery time is usually shorter than with traditional blepharoplasty.

Blepharoplasty

How blepharoplasty has performed in more recent times

In the 1970s, laser blepharoplasty was introduced as a less invasive alternative to traditional surgery. Laser blepharoplasty is a form of eyelid surgery that uses laser technology to perform the procedure. It's a minimally invasive procedure that can help reduce sagging skin, wrinkles and puffiness around the eyes.

During the procedure, a laser is used to make small incisions in the skin around the eyes. The laser is then used to remove excess skin, fat and tissue to create a tightened, youthful appearance. The laser can also be used to stimulate collagen production, which improves the elasticity and firmness of the skin.

One of the advantages of laser blepharoplasty is that it's less invasive than traditional blepharoplasty, which involves making larger incisions in the skin. This can lead to less scarring, bruising and swelling and a faster recovery time. Because the laser closes the blood vessels during the procedure, there is also less bleeding and a lower risk of complications.

Brief History of Tear Trough Fillers

Under-eye fillers are a testament to the evolution of cosmetic procedures as innovative technologies and techniques have made treatments safer, more effective and more accessible.

The use of undereye fillers, also known as tear trough fillers, is a relatively new trend in cosmetic procedures that have gained popularity in recent years. However, the concept of enhancing the eye area with injectables can be traced back to the early 1900s.

One of the first attempts to plump up the under-eye area took place in the 1920s when paraffin injections were used to treat wrinkles and hollows under the eyes. Not surprisingly, this method was deemed unsafe due to the high risk of complications such as inflammation and infection.

In the 1980s, collagen fillers were introduced and quickly became popular as a non-surgical option to improve facial features. However, collagen had its limitations as it didn't last very long, and the body could sometimes develop an immune reaction to it.

The development of hyaluronic acid fillers in the 1990s revolutionised the field of cosmetic injections and offered a longer-lasting, safe and effective alternative to collagen. In particular, tear trough fillers became increasingly popular in the 2000s to treat the unique anatomy of the under-eye area and its concerns, such as dark circles, hollows and bags.

Today, treatment with fillers for the eye area has evolved into a minimally invasive, quick and safe procedure that can be performed in one quick session with no downtime afterwards. Advanced techniques, such as the use of microcannulas, have made the procedure more comfortable and reduced the risk of bruising.

Bboth treatments aim to improve the appearance of the eye area, but each comes with its own pros and cons. 

Differentiating Tear Trough fillers and Blepharoplasty

1. Invasiveness

One of the main differences between under-eye fillers and blepharoplasty is the degree of invasiveness. Dermal filler is a minimally invasive procedure that usually takes less than an hour, and patients can usually return to their normal activities immediately afterwards. There may be temporary side effects such as bruising, swelling and infection, but these are generally rare and resolve within a few days. In contrast, blepharoplasty is a surgical procedure that is usually performed under general anaesthesia and may require an overnight stay in the hospital.

Recovery time varies, but patients may need to stay away from work for several days or even weeks and avoid strenuous activity for several weeks after the procedure. Blepharoplasty has a higher risk of complications than fillers for the eye area, such as bleeding, infection and problems with anaesthesia. In addition, visible scars, asymmetry or other aesthetic problems may occur if the procedure isn't performed properly.

2. Longevity

The duration of the result is another major difference between under-eye fillers and blepharoplasty. Tear trough fillers are a temporary solution that can last between 6 and 18 months. This depends on the type of filler, the amount injected and the individual's metabolism. Over time, the body gradually absorbs the filler and the treated area returns to its pre-treatment state. However, patients can maintain their results by getting touch-up injections every few months or as needed. In contrast, the results of blepharoplasty are usually long-lasting. The ageing process does continue, but by removing the excess tissue, the results of the procedure can be maintained for years. In some cases, the results of blepharoplasty can even be permanent.

3. Cost

Cost is another important factor to consider when deciding between under-eye fillers and blepharoplasty.

The cost of under-eye fillers depends on several factors, such as the type of filler used, the amount injected and the provider's fees. In general, the undereye filler is less expensive than blepharoplasty. The average cost of undereye fillers in the UK is between £500 and £1,500 per treatment, depending on the factors mentioned above. Patients must also factor in the cost of touch-up injections as needed to maintain the result.

Blepharoplasty is a surgical procedure and, therefore, usually more expensive than fillers for the eye area. The cost of blepharoplasty can vary greatly depending on factors such as the surgeon's fee, the complexity of the procedure and the geographical location. The average cost of blepharoplasty ranges from £3,000 to £7,000. This usually includes the surgeon's fee, anaesthesia, facility costs and post-operative care. However, depending on the case, the total cost can be higher.

4. Patients Goal

Another point to consider when choosing between under-eye filler and blepharoplasty is your specific concerns. Filler is most effective for patients with hollows or dark circles as it helps to plump up the skin in this area. It also works well for mild to moderate wrinkles and folds. Under-the-eye filler can also be combined with other non-surgical facial treatments, such as a Liquid Facelift or Botox, for more comprehensive facial rejuvenation. However, it may not be as effective for patients with severely sagging or excess skin. Blepharoplasty, on the other hand, is more suitable for patients with significant sagging or puffiness of the upper or lower eyelids.

In some cases, a patient may not be a good candidate for either treatment.

When To Avoid Under-eye Fillers or Blepharoplasty?

For example, patients with a history of bleeding disorders or those taking blood-thinning medications aren't good candidates for blepharoplasty, as they may be at increased risk of bleeding during and after the procedure. Patients with certain medical conditions, such as uncontrolled diabetes, high blood pressure or heart disease, may also not be able to undergo surgery safely.

Under-eye fillers, on the other hand, may not be suitable for patients who are allergic to any of the filler ingredients or currently have an active skin infection or inflammation around the treatment area. Patients with a history of autoimmune diseases such as lupus, rheumatoid arthritis or scleroderma should also exercise caution when considering filler injections.

Before undergoing any cosmetic procedure, it's essential to disclose your medical history and medications you're taking to your provider. They will evaluate your history and perform an examination to determine if you're a suitable candidate for the procedure. In some cases, they may even recommend an alternative treatment or advise against the procedure altogether for your well-being.

What's The Next Step?

As you can see, both fillers for the eye area and blepharoplasty have their advantages and disadvantages. We hope this blog has given you a better understanding of the two options. Ultimately, you should make the decision between these treatments after a consultation with a qualified doctor who specialises in each treatment. This will help you better understand the benefits and limitations of both options and make the best decision based on your goals, preferences, medical history and budget.

At Dr Aesthetica, we are one of the leading non-surgical cosmetic clinics in Birmingham. Our experienced team of doctors can help you choose the best treatment option that suits your goals, preferences, medical history and budget. Contact us today to schedule a consultation and take the first step towards achieving a rejuvenated, youthful eye area.

Post Reviewed by: Dr Baldeep Farmah
Medically Reviewed on: 2nd March 2023
Dr Baldeep Farmah is the Medical Director and lead Doctor of Dr Aesthetica, a Medical Aesthetic Clinic.

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