The more about tear trough correction and, indeed, any treatment you are considering having, the better. Most people who come to EdenMed Aesthetics and Rejuvenation Clinics in Chelsea and Bournemouth for tear-trough filler have the same complaint, "I always look tired because of the hollows, shadows and dark circles under my eyes". No matter how much sleep you get or how many serums or creams you tap on, the problem never seems to get better. And of course as we get older other changes in our skin and bone structure just make the problem worse. In this time of social media, selfies and 'influencer' culture, more and more people, both male and female, come to me looking for an effective, safe, comfortable and long-lastng treatment. 

Volume loss under your eyes is what filler works best for, but it can also be used in some cases to treat puffy bags (known as pseudoherniation of orbital fat, or obital fat prolapse). When used in the case of puffy eye bags, what is actually being treated is the hill-valley-hill effect of puffy skin projecting forwards, then a depression in the skin below follwed by a further projection forwards at the cheek level. It is the hill-VALLEY-hill that causes a dark shadow or tired look in this scenario. What filler won’t help with is pigmentation. If your dark circles are actually caused by darker pigment in your skin, filler will only accentuate them. Not sure how to tell? Hold a mirror and look up so that bright overhead lighting hits you directly. If the shadow disappears, your dark circle is caused by a hollow, you might be able to see the hollow as a curved or "S" shaped depression in the skin that extends onto the front of the cheek. If the colour is still there, it’s more likely pigment. If in doubt I recommend you book in for a consultation.

As dermal fillers and their use as treatments in the UK are not considered to be prescription-only devices, medical treatments or surgical treatments, there is no regulation on the type of filler, the method of injecting or who can inject. In our opinion, you take your life in your hands!  In the surgical world, of which Dr. Sam has extensive experience, there are many aspects that ensure the highest likelihood of a good outcome. These include the pre-treatment assessment, the correct diagnosis, the best treatment for your condition, a full and frank discussion about the different options (their pros, cons and risks), the surgical team and the aftercare. BUT, the single most important factor in surgical outcome is the skill and expertise of the operating surgeon. What makes you think that injecting filler into your face, which has a risk of vascular occlusion, skin necrosis, blindness and stroke (all approx. 1/100,000) is any less important? EdenMed Aesthetics is of the strong belief that a fully trained medical profession, especially someone with extensive surgical skill, expertise and knowledge, is the best person to treat delicate areas such as the tear trough. This is especially pertinent since Dr. Sam comes from a background of ophthalmic and oculoplasic (eyelid) surgery.

It's also important to understand that some fillers are liscenced in some countries for specific indications, such as lip or cheek enhancement. There are many fillers available that are either licenced for a particular area, or have a particular quality and property, that make them an ideal filler to use in a different, unlicensed area of the face or body. We use the same products that are approved for other areas of the face and we put them in in the exact same way. This is very common practice in medicine as a whole and facial aesthetics in particular and is safe, accepted practise when done ethically and openly, with the best product and after discussion with the client.  The tear trough carries the same risk of necrosis as your lips, although it's less frequently talked about. As mentioned above, this and other complications occur when a provider accidentally injects into an artery and causes premature death of cells. The tear trough area is full of blood vessels. Remember also that your undereyes are a tricky area to get right and you should trust yours only to a doctor with plenty of experience. To reduce the chance of potentially devastating complications Dr. Sam only ever uses a microcannula when treating tear troughs. This also greatly reduces the risk of getting a "black eye" from the significant bruising that can occur when standard sharp needle techniques are used. The risks can never be zero though!

Don’t go to a non medical injector.

Get all the chemical peels and laser hair removal your heart desires at a med spa, but please don't let anyone who isn’t a certified doctor or plastic surgeon inject under your eyes, no matter how persuasive the Groupon deal or high-tech the waiting room. There’s a steep learning curve to this area because you’re trying to camouflage very subtle fat or volume loss on a dynamic area of your face. It requires extra precision.  Do your research without price shopping, then double-check the doctor’s qualificaions, look at before-and-after photos and their reviews/recommendations.

Make sure you’re getting hyaluronic acid fillers.

Most doctors use hyaluronic acid dermal filler for your undereyes, especially if it’s a patient’s first time. It’s worth inquiring during your consultation to be sure. The benefit is that this material can be easily dissolved with hyaluronidase (an enzyme already found in our bodies) should you not like the results or want to take it down a touch. Forty-eight hours after an injection of hyaluronidase, and the filler will have almost competely gone. Two other important aspects of ensuring you see a medically qualified aesthetic doctor is that in the rare event of vascuar necrosis hyaluronidase will be used to immediately dissolve the filler. Other medication may also be used at the same time, so ensure your injector has both hyaluronidase and the medical and surgical experience to recognise when a complication occurs and be ABLE to treat it. The second point is that many HA fillers contain the numbing agent lidocaine. And whilst Hyaluronic Acid is a natural component and very unikely to cause an allergic reaction, lidocaine and indeed hyaluronidase, may cause allergy or anaphylaxis in some individuals. You need to be confident your injector would know how to recognise and what to do if you developed anaphylaxis. SAFETY IS OUR TOP PRIORITY!

Filler isn’t permanent, but it does last longer under your eyes.

There’s no definitive answer to the question of how long injectables last; absorption varies from person to person. Because the tear trough isn’t a very mobile place (unlike your lips or forehead), it takes your body longer to metabolise and absorb the hyaluronic acid. This means your results should usually last between six and twelve months. The choice of hyaluronic acid filler for this area is imprtant and relates to both the layer of tissue in which it is placed and the method of placement. Dr. Sam tends to prefer a very fine, smooth filler that forms a flat sheet in the subcutaneous (most superficial) layer of the skin. He always uses a microcannula for comfort and safety. The other important issue is something called the Tyndell Effect. This is a bluish discolouration of the skin by placing a usually thicker more dense filer too superficially. This is avoided with the fine fillers that are used in our clinic for the delicate tear trough area. Of note, some patients have clinical findings that mean surgical blepharoplasty is a more suitable choice. You can find medical literature on surgery here.

Having needles around your eyes is just as unsettling as you’d expect.

...And that's why we DON'T use a needle!

You’ll see a difference right away, and there’s no downtime.

There's no need to reschedule a date or take the afternoon off from work; you can go about your life as usual the moment you leave the doctor’s office. This is especially true, as you would expect, for minor treatments. Depending on the severity of your under eye hollows or puffy eyebags, the placement layer for the filler, the technique used and the amount of filler needed for correction, there maybe a minor degree of swelling that can last up to 6 weeks. This is more commonly seen in people over the age of 40 years in our clinic's experience. Hyaluronic acid is hydrophilic, which means it attracts water to itself. It can, infact, draw up to 20x ts own volume in water, but don't worry, it invariably resolves.

It’s normal to need a follow-up appointment for some minor tweaking.

The undereye is the most common place to need to tweak again. The first time someone gets filler there, they'll be asked to come back in six weeks for a review if they feel it needs a tweakment. That might mean adding a few more drops of filler or using a pinch of hyaluronidase to flatten out any minor puffiness.