Dr Tim Reacts: Why I Stopped Filling Tear Troughs

Cosmetic Physician, Dr Gavin Chan from ‪@viccosmeticinstitute‬ went viral with a thought provoking video explaining why he no longer fills tear troughs.
It's the number one video Dr Tim gets asked about, so he's made a video responding to Dr Chan's concerns, and explaining why he still chooses to treat tear troughs.
Do you treat this area?
Chapters -
0:00 - Intro
04:27 - Puffiness after tear troughs
05:13 - Don't inject the orbit
07:09 - Have you been doing tear troughs wrong?
Useful links:
Dr Chan's tear trough video: • why I stopped filling ...
Dr Chan's brilliant KZbin channel: / viccosmeticinstitute
Dr Tim's filler longevity interview with Dr Master: • How Long Does Dermal F...
Dr Tim's tear trough complications interview with Dr Master: • Tear Trough Complicati...
Dr Master's Instagram: / drmaster_md
Dr Mendelson's Instagram: / drmendelsonmelbourne
If you struggle with worry over causing complications, you would benefit from Dr Tim's live webinar about how to overcome complications anxiety. Register here: www.aestheticcomplications.co...
Dr Tim's social media:
Facebook: / drtimpearce
Instagram: / drtimpearce
Website: drtimpearce.com/
Podcast: open.spotify.com/show/20kUIxU...
#dermalfiller #medicalaesthetics #aesthetics

[@haven_from_me]

Dr. Chan's video was excellent and your very respectful response was also excellent. Thank you

[@annpringle8219]

Great video!

[@lottieeliza6699]

Great video - thank you so much! X

[@CarlyleKayla]

really liked this video. i thought dr chan made excellent points but you made some as well. i think the disney animator analogy is so interesting and a great way to explain that people who get fillers and aesthetics done aren't simply a reflection of their ego/a want to achieve beauty studies

[@DrTimPearce]

Glad you enjoyed it!

[@pankajthakrar1679]

Thank you Tim, I had watched Dr Chan’s video again and am more apprehensive about filling tear troughs now but your balanced comments have been a bit reassuring. It is worrying when very experienced injectors like Dr Chan advise against certain treatments. Thank you for making this video

[@DrTimPearce]

I think when you unpack the detail of the video he is still treating tear troughs, but calling it 'supporting the ligament'- to the casual observer it's the exact same procedure.

[@mycatsnameiskaren8253]

That's exactly why I'm here. I've watched that same video and it made me even more hesitant. I'm thrilled to watch this video and see your POV. Thank you so much Dr.Tim.

[@drmaster2907]

Thanks for citing and the references. At this stage, I see the worst of the complications. There are many happy patients without complications. Not ALL filler lasts for years and cause issues. Management of filler like a sculpture however is wise, with careful monitoring and dissolving as required.

[@AmardeepSingh-gh8wn]

Legend!!!!

[@tonyg4058]

Shame you don't treat patients anymore, hard to find someone very knowledgeable like you particularly in the UK

[@DrTimPearce]

There are many many medical professionals around who are incredibly knowledgeable in this field. They may just not be in your doorstep. Our clinicians at our Manchester clinic are always there to support. @SkinViva Kind regards Mary. Clinical advisor for Dr Tim

[@TheUrbanAesthete]

What sucks is now this new wave of establishments against tear trough filler has made it hell to find somewhere to get it done! And I'm in LA, what I would consider to be a major mecca for cosmetic procedures!

[@rlittleworth]

I’m in LA too. Did you find anywhere?

[@michelle4america]

I had tear troughs filled with terrible results. Allergans Vullore destroyed the collagen. Plus, the physician hit a blood vessel leaving to more disclororation.

[@user-jj7us1lg6u]

Thx alot

[@diastemma]

Do you recommend to use cannula in order not to penetrate the orbital septum? Great channel, great topics, thank you, Dr. Tim!

[@DrTimPearce]

A cannula is a good tool to prevent this yes.

[@anmolchattha6845]

Cannula can still penetrate

[@nathaliegignac2681]

I have been watching your video for a few months and really love it I just want to say that I my self went to a few dr. Who inject me under the eyes and all 3 times a total disaster the thing is like they all think that 1 patient fits to all of theme you really have to understand your patients anatomy and if your not confident enough then please to all the other dr on here just dont inject shame on dr or nurse practitioner who dosent know what thete doing they make you sign a waiver so you can't do anything after if it goes wrong I hade bad experience from filler and even blepheroplasty done with that maybe here in florida we need a dr. Like you who understand and teaches other dr. To do it 😊

[@DrTimPearce]

Sorry to hear of your troubles. Kind regards Mary. Clinical advisor for Dr Tim

[@arinanegut6478]

great !

[@BabyBear046]

What treatment is recommended for people with genetic/dark circles since childhood?

[@chewie94116]

Dr. Gavin Chan seemed to literally stopped doing all cosmetic procedures based on his latest videos. I agree with you that each patient needs to be assessed and treated individually.

[@obmitty1]

😂😂😂

[@CK-vf4nx]

Exactly and also discourage ppl have ANY cosmetic procedure…like what???😂😂

[@Dandelion_flight]

Nah I don’t believe he has stopped. Plus he has other injectors in his two huge clinics doing cosmetic works. I think it is case by case basis depending on patient’s situation.

[@dogbums8548]

What about fat transfer??

[@eoin68]

Hello I’m 27 and I don’t have lines or wrinkles under my eyes but I have discolouration and blueness. Also very thin skin and not a lot of fat under this area. What is the best way to usually treat this type of problem?

[@carmelmontgomery4900]

So do fillers only stay longer because of poor placement or even if they are placed correctly??

[@Enjoytheshow435]

Very deep analogy. We portray evil this way because we are evolutionary hardwired to perceive evil-looking faces this way, not the other way around! We’re not indoctrinated by our culture to see beauty in a certain way and not the other. Culture is actually the outcome. So many evolutionary reasons for that. I think survival of the prettiest is a good read for people who want to know the science behind the mathematical equation of beauty. Spoiler alert, it’s not the western culture or the patriarchy. Evolution by sexual selection is to blame. I’m Middle Eastern, I have very hollowed eyes. I’ve learned to heat them where I grew up, in a Middle Eastern country where a lot of people look this way! If I had grown up in the states, I would’ve definitely blamed that self hate on the western culture , it’s tempting. It’s easy, and it feels good to be a victim. Human nature, we hate to admit that there is an absolute beauty. Toddlers stare more to faces we considered conventionally beautiful. Beauty actually is a matter of just millimeters and we can’t fool our brain to see beauty where it doesn’t exist. Yes,I hate to Admit that as the next person but it’s the truth. I removed my 17 years fillers from under my eyes yesterday because I’ve learned to love myself the way I am. I can’t stop staring at my "beautiful" hallowed eyes, but I would be a fool to think that my hollowed eyes make me look healthy or well rested to people or even to myself. They’re not beautiful, but they are more beautiful than filler’s puffiness. I will take that.

[@DrTimPearce]

I agree with you. It's fashionable to blame the patriarchy for the fact that youth and feminity has a value, but it comes from nature not a man's head. If you can accept that you do not need to be valued at the top level in every category by other people, but instead to value yourself for all the other attributes which involve choice, like being honest, compassionate, skilled etc, then you will achieve the ultimate peace and be a more developed person. However, it is not an easy path.

[@lmo1886]

Beautiful

[@rozaucja8612]

How do I fix my undereyes that are now puffy due to hyaluronic acid, lymphatic blockage? I do not want to do hyaluranadize.

[@gust9464]

Thx for the detailed information. Do you recommend filler over PRP or PRF?

[@DrTimPearce]

Each product has its advantages. And it’s drawbacks. But we like filler and we because we only really use it we will ultimately recommend it. PRP is a very safe and natural alternative but it won’t have the volume that filler has. Prp and prf will brighten and improve the quality of the skin in that area. Kindest regards Mary. Clinical advisor for Dr Tim

[@jennyquezada9644]

Where are you located?

[@weeeeoooow]

I've watched Dr Chans video as I'm considering tear trough filler. I feel more confident now watching your take on it , regarding older patients. I'm in my late 50s and I've never had any type of fillers/ treatments at all so I am a little nervous. I do have small puffy type bags and am prone to puffiness due to blocked nose/ sinus which I've had all my life. In your opinion ( though of course I'll go for a face to face consultation) should I consider tear trough or maybe filler in the cheek area below the socket line to soften / even the bags out? Thanks in advance.

[@DrTimPearce]

Thank you for your question. If you have any degree of. Toning puffiness then tear trough filler isn’t ideal for you as it will just become worse. Absolutely have a consultation. See who feels right for you and if you feel safe in their company. Cheeks certainly can help in the exact way as you have mentioned. Kind regards Mary. Clinical advisor for Dr Tim

[@user-cj1hz9ve3x]

I am like 17 years old and i have tear trough so how can i permanently solve this without having any side effects

[@moon3173]

why not disconnect the ligament??

[@tianxiaojun]

asking the same question

[@shevy1227]

what about volite skin boosters with partially cross linked HA just under the dermis close to the eye? I've seen people with good results from that

[@DrTimPearce]

Volite isn’t something we use at clinic so we can’t comment from experience. But all skinboosters have pros and cons, but really it always comes down to correct patient selection. Anyone with already poor lymphatic drainage under the eye won’t be a good candidate for both tear trough treatment with either filler or skin booster. Anything crosslinked partial or full, has a risk of occlusion. But yes skin boosters can be very good at improving tissue quality. It’s not really a volumiser. Kind regards Mary. Clinical advisor for Dr Tim.

[@fp8237]

What would you suggest for someone who has this issue through genetics? I have had shadows since childhood. Not sure to just invest in good creams/gels and not surgery

[@DrTimPearce]

Go and visit an experienced practioner who can discuss your facial proportions and discuss with you different approaches and alternatives. Many people with hollow under eyes that run in the family have successful treatments but some require potentially cheek treatments before hand and some people are not suitable. It’s always sensible to try the least risky options first if your not ready for injectables Kind regards Mary. Clinical advisor for Dr Tim.

[@filizonar9532]

Türkiye den sevgiler dr Tim.

[@weeeeoooow]

Just reading through the comments and wondering how long the PDO thread treatments lasts please. Great informative video btw.

[@DrTimPearce]

It’s not something we offer I’m afraid so we can’t comment with certainty.

[@Dandelion_flight]

I wouldn’t think PDO threads works. It is controversial even amongst practitioners.

[@anonuser1239]

For those younger patients with tighter ligaments, are there alternative solutions/treatments that they can try to resolve tear trough deformities?

[@steffdiaz12]

Prp

[@mariewiefel4542]

Would PRF Bio Filler work better for the tear troughs?

[@DrTimPearce]

Platelet-rich plasma will improve the quality and pigmentation of skin but won’t do much for volume loss if this is the reason for under eye shadow.

[@ElaineTB1]

My eyes always looked worse after tear trough? Had to dissolve both times 😢

[@petermccolgan790]

Hi, what filler would you recommend for under the eye 👁?

[@DrTimPearce]

I like to use Juvaderm volbella in the tear trough but Teosyal’s redensity 2 is another good quality product for this area.

[@Dandelion_flight]

@@DrTimPearce I had Teosyal done but my injector was a bit heavy handed. I looked immediately perfect it was amazing but over a year I could see a bit of lumpiness so she dissolved a wee bit here and there over few sessions. It is great after that. I love the result. I would say I never regret on having my tear troughs done. It changed my life!!! I used to hate taking photos cos my eyes looked tired and aged but not they look young. Patients definitely need to research and educate themselves.

[@JasminnnnnnE]

Hi Dr Tim, you filled my tear troughs when I was 25 and I was really happy with the result. I then had them refilled elsewhere and have puffy bulges under my troughs when I smile for the past 2 years and the filler shows no sign of dissolving. Is this something that can be fixed?? Thanks 🙏

[@DrTimPearce]

Thanks for messaging on Instagram too, hope we now have a plan!

[@JasminnnnnnE]

@@DrTimPearce Thank you again for you help and advice, it's really appreciated :)

[@lcherri3079]

@@DrTimPearce What was your suggestion for this? I have the same thing. The first time I had belotero which dissolved on its on and looked very natural. The next time I got volbella which appeared to sag and look lumpy after 2.5 years and I got it dissolved and redone again with volbella (wasn’t happy about the providers choice at the time). The same thing has happened again after 2 years

[@38hoperenee]

What about PDO threads? I have heard a lot of positive things about them especially around the eyes.

[@simslover246]

PDO threads are great for tear troughs and eye bag correction

[@mediainfo-mf6dh]

I think a lot of injectors tell people 6 to 12 months for filler so they will keep coming back and getting more. It's more of a sales technique these days.

[@DrTimPearce]

Depending on the viscosity of the filler will depend on how quickly it is metabolised by the average patient. There is of course varying differences of the “average“ patient. So a strict time frame can’t be given. This is patient choice. No one is making them return at that stage of course. Kind regards Mary. Clinical advisor for Dr Tim

[@rolawehbe3327]

What about the light eyes treatment? Is it less risky than the tear trough filler?

[@trinityp8575]

What is a light eyes treatment?

[@parvanehbarron6194]

How about going PRP there. Less danger and better results

[@marcosfernandez4523]

Yo estoy haciendo prp y carboxiterapia, con buenos resultados

[@Jtroblox337]

Always so helpful... Thank you... I wish you allowed non medics in your seminars

[@uoxoudollTV]

Can’t go without my eye filler lol

[@truth-alwayswins]

Topilase makes the application-and potential removal of filler gone wrong-much more palatable for those nervous about tear trough fillers. It’s a topical hyaluronidase that is being used with success in Europe, developed by a French doctor. Apparently allows for more precision and control than the injectable version. Topilase is expected to be in doctor’s offices in the States in 2023.

[@DrTimPearce]

We will be looking into this product too in coming months. Kind regards Mary. Clinical advisor for Dr Tim

[@tracymullane8818]

Couldn't you just use the hyaluronidase topically? Even mixed with some DSMO for a bit of skin penetration? Or microneedling?