Alexander Rivkin, MD
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Alexander Rivkin, MD
Plastic surgeon | Views: 244076

Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English

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Ask An Expert > Alexander Rivkin Message Board > I'm female, 49, with hollow tear troughs. The rest of my face looks good. I had a medium tca peel to make my under eye skin less crepey.
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Anonymous, AL
I'm female, 49, with hollow tear troughs. The rest of my face looks good. I had a medium tca peel to make my under eye skin less crepey.
I'm going to wait a month and then try restylane in the tear troughs. My facial plastic surgeon says cheek implants to push the trough area up combined with a lower bleph would give me a better result. What do you think?

Facial plastic surgeon
Fleming Island, FL
United States
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Correction of tear troughs  June 28, 2010 1:21 PM

Hyaluronic acid gel fillers (Restylane, Juvederm, etc.) really work well in tear troughs. It's also inexpensive compared to surgery and is reversible.

Blepharoplasty usually does *not* correct tear troughs unless a SOOF lift is also combined with it.

Cheek implants also do not correct tear troughs or create any real lifting (beyond the initial swelling from surgery).

I usually recommend a temporary filler like Juvederm first. If that works well and the patient wants a more permanent solution, Artefill can be *very* cautiously used.

All the best,


Plastic surgeon
Atlanta, GA
United States
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Facial implants don't age with the rest of your face  June 28, 2010 2:15 PM

I'm not a fan of most facial implants because, as you age, the implant stays where it was placed. The rest of your tissues will stretch and sag, and the implant will end up looking quite fake. Worse, an implant can become encapsulated and can feel very hard or even be visible.

I would go with something like Restylane or Juvederm in the tear-troughs, maybe combined with a lower blepharoplasty.

cheek implants don't....  June 28, 2010 8:38 PM

Cheek implants don't really cover the tear trough area. The TT area is medial maxilla bone and cheek implants are more lateral and lower than where the TT is.

Plastic surgeon
New York, NY
United States
View My Professional Profile
  June 29, 2010 11:43 AM

Implants are a bad idea and Restylane is far from being good for everyone. Fat transfer should provide the best results that are permanent and easily if needed correctable.

Plastic surgeon
Baltimore, MD
United States
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Tear trough  June 29, 2010 1:36 PM

See a BOARD CERTIFIED PLASTIC SURGEON, have a complete analysis of your face and what bothers you and discuss your options, risks and potential complications. Then decide.

Plastic surgeon
Beverly Hills, CA
United States
View My Professional Profile
  June 30, 2010 8:04 PM


I would really need to see photos to give you the best advice. If you wish, you may send any photos to Lisa, my patient care coordinator at Lisa@spaldingplasticsurgery.com and I would be happy to evaluate them for you. You may also benefit from fat injected in the tear trough area. Thank you, and best of luck to you.

Dr. Nassif

Plastic surgeon
Miami, FL
United States
View My Professional Profile
  July 1, 2010 3:30 AM

Before such an aggressive treatment try a filler like the HA's (Restylane, et al) or fat transfer to the tear trough. From MIAMI DR. B

Plastic surgeon
los angeles, CA
United States
View My Professional Profile
you are right  July 5, 2010 4:57 PM

restylane is easy, inexpensive and, most importantly, easily reversible with hyaluronidase. it is true that not everyone is a good candidate for restylane injections into the tear troughs. but if you are, it would certainly be the easiest option.
the effect in the tear troughs lasts for a very long time - 2 to 4 years - due to either the area being very hydrated or a big collagen stimulation effect in that area particularly.
for those reasons i really do not see a reason to do a procedure like fat injection or implants that is more invasive, much more expensive and not reversible.
the most important consideration in choosing your injector is experience, not board certification. you want to make sure that your doctor has done hundreds of these procedures specifically. a board certified plastic surgeon with lots of experience in breast lifts is not the person you want doing this procedure.



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