Correcting the Tear Trough Deformity
Tear trough depressions can occur at all ages. Patients come in and complain to me that they appear tired and try to conceal their lower eyelid hollows with concealer. Most patients will have a sunken appearance and dark shadows cast over their lower eyelids. The hollowness is due to the attachments of ligaments around the eye along with volume loss.
There are various classifications in the literature describing the severity of the deformity.
Hirmand’s 1 classification includes Class 1, 11, and 111. Class 1 patients have volume loss in the medial tear trough and flattening extending to the medial cheek. Class 111 represent patients with full depression along the whole orbital rim.
The patients with the most severe depression are the hardest to treat.
There are various treatments including surgery, chemical peels, laser resurfacing, volume replacement and a combination of procedures.