When is eyelid surgery recommended for tear trough hollows?

Tear trough hollows are depressions between the lower eyelid and upper cheek. Shadowing can be influenced by bone shape, skin thickness, soft-tissue volume, lower-eyelid fat, pigmentation, and fluid retention. Lower blepharoplasty can reposition or remove selected fat and address some skin laxity, but it may not correct dark colour or every type of hollow. The examination should consider the eyelid-cheek junction as a whole.

See a qualified oculoplastic, ophthalmic, or facial plastic surgeon for an in-person examination. Mention dry eye, allergies, thyroid disease, previous eye procedures, contact-lens use, and medicines that affect bleeding. Ask whether the hollow is caused mainly by volume, laxity, shadow, or pigmentation, and whether surgery, an injectable approach, skin treatment, or observation better matches the finding. Request clear aftercare instructions and a follow-up plan.

Seek prompt review for a new one-sided hollow, eyelid swelling, pain, redness, double vision, or a change in sight. After surgery, urgent care is needed for sudden vision change, severe pain, marked asymmetry that is rapidly worsening, or heavy bleeding. These symptoms require assessment rather than assuming they are part of normal healing.

Ask what tissue is creating the hollow, whether lower blepharoplasty would improve the shadow, and what it cannot change. Discuss dry-eye precautions, incision placement, recovery, alternatives, and how the result will be reviewed as swelling settles.