Dear Dr. Seckel, I recently (3 months ago) had tear trough implants placed to correct dark circles under my eyes. I now have a lump which looks like the end of the implant protruding from my right cheek and I can see the outline and it looks as though the right implant is crooked. On both sides the dark circle under my eyes near my nose, which is what I wanted to correct is still visible. Can this be corrected? Thank you, Beth, London, UK
Dear Beth,
I am sorry to hear of your problem. I do not use tear trough implants to correct dark circles under eyes any longer because of these types of difficulties and the risk of complications.
I find that the tear trough implants are often displaced by the contraction of the overlying orbicularis occuli muscles. These are muscles which control the lower eyelid and when they tighten with smiling they squeeze and can displace the tear trough implant toward the side of the cheek away from the dark circle near the nose.
The tear trough deformity for which the tear trough implant was designed is very different from the arcus marginalis deformity which causes dark circles under the eyes and in my experience the tear trough implant frequently does not correct the dark circles under eyes or arcus deformity.
The procedure I now use to correct dark circles under eyes or the arcus deformity is the transconjunctival arcus marginalis release with fat grafting or fat repositioning. Through this approach I can place the fat graft beneath the dark circle under the eyes where it begins, near the nose, and all along the dark circle under the eye as it runs toward the side of the face. In my hands this procedure gives a better reult tan the tear trough implant. In older patients who have a tear trough deformity, and in some patients who have a particular “hollow eye deformity” I will still use the tear trough implant usually in combination with a fat graft.
The displacement of the tear trough implant that you describe is common when it is used to correct dark eyelid circles, and I fear the implant may need to be removed or repositioned. Of course you need to consult your surgeon about this and ask him/her if an arcus release and fat grafting can be done.
In the meantime if you were my patient I would have you begin massaging the lump and the implant to see if you can improve the position of the tear trough implant-after 3 months this should be safe to do, but ask your doctor first. For more information on dark circles under the eyes contact me or read Save Your Face. Be sure to sign up for my free email newsletter.
Concord, Massachusetts
Boston, Massachusetts
978-369-4499