It’s important to realise that the tear trough and the cheek are immediately adjacent to each other anatomically and are therefore intimately connected. When your injector is assessing and treating the area they must consider them together..
The front cheek needs to support the tear trough to achieve a good result in the tear trough.
If the front cheek doesn’t give enough support then the trough will be very long. It is not the “trough” area that needs to be injected first, it it the midface or front cheek area that needs to be injected.
When it goes wrong
To attempt to fill the trough when the patient does not have an adequate front cheek can lead to poor results.
The tear trough shouldn’t be considered in isolation
For those wanting to improve their under eyes, the trough should not be assessed in isolation, the lid-cheek junction and the cheek need to be considered to create the best results. The aim in that area is to have a very smooth transition at the lid-cheek junction, between the cheek and the trough.
All of the above areas need to be considered together for optimal results
Example of tear trough and cheek
I have share this side view below to show how the cheek and tear trough are intimately connected. This patient had her cheek area treated with the tear trough. If the immediate under eye area only had been treated, the results would not have been optimal.
When injecting filler in those with concave, depressed or flatter front cheek anatomy, shortening the tear trough by addressing the cheeks is vital.
Skinbooster
We also use skinbooster to help to smooth the transition between the junction of the lid and cheek.
Skinbooster can be used as a blanket over the whole skin of the lower lid, to improve the texture and the fine lines.
It is also very useful over filler as filler works best when the overlying skin quality is optimised