The junction between the eyelid and the cheek, also known as the “tear trough”, is an area of the face that makes us appear tired and older when it starts to deepen. It is caused by the anatomic relationship of the eyelid and cheek with bulging eyelid fat and an adherent ligament or fibrous band accentuating the depth and visibility of the tear trough. Frequently, associated shadows that are created will make it appear worse.

A more rested, youthful appearance is achieved when the junction between the eyelid and cheek is blended. The use of injectable fillers is an effective, non-surgical way to improve the area by camouflaging the depth of the tear trough through the placement of Restylane® or BELOTERO BALANCE®. Fat grafts can also be used to effectively conceal the depth of the tear trough. Treating the cause of the baggy appearance, however, requires a surgical approach that handles not only the bulging fat but the tear trough ligament that defines the junction between the eyelid and the cheek. The procedure, known as transconjunctival fat transposition blepharoplasty, involves an incision on the inside of the eyelid through which Dr. Forley releases the tear trough ligament from its bony attachment. The junction between the eyelid and the cheek is then filled with the fat of the lower eyelid to create a youthful, natural, well rested appearance. Any excess fat is removed to enhance the final outcome. A long lasting result is achieved with this technique which can be combined with other procedures to reverse the signs of facial aging.