02/21/2026
Tear trough filler use is very common. We now know that HA fill can last in excess of 10 years in the lower eyelid and upper cheek region. It can often migrate and expand to present as a new fullness in the lower eyelid. It is important to identify a history of filler use and to dissolve the filler using a hyaluronadase injection prior to surgery. HA filler can in the upper cheeks can present with prolonged swelling following blepharoplasty surgery. This beautiful patient of mine who is in her early 60s is photographed approximately 10 months following surgery. She underwent upper and lower blepharoplasty surgery with micro fat grafting to the upper cheek region. A fractionated erbium laser was used to improve the skin quality of the eyelids. Prior to surgery, her previous HA filler was dissolved in the office setting. This can be seen as a fullness in the tear trough region in the preoperative photograph. She is thrilled with her new cleaner appearance. I am grateful for her trust.