06/10/2026
Don’t fall foul of fillers!
Our thanks to this lovely patient of ours, who suffered a well intentioned but ultimately unhelpful set of treatments with fillers to the tear trough and under eye groove (orbitomalar sulcus), at the junction of the lower eyelid and cheek. This led to bulky ‘filler festoons’ of the orbicular muscle and underlying SOOF deep fat of the cheek.
Jonathan undertook a restorative lower eyelid blepharoplasty designed specifically to address the “filler festoons”, to re-layer the lower eyelid and cheek and restore the contours.
The history...
Initially there had been filler injections, which failed to “banish the shadows”, and these were followed by yet more filler injections, which inevitably made things worse. This was followed by attempt to “dissolve” the fillers, but this just made things lumpy and uneven and resulted in yet more fillers being placed. When this did not help, a temple lift, and “micro liposuction” were undertaken; but did not help…
Why was this the case?
Craniofacial plastic and oculoplastic surgery for reconstruction, restoration, and appearance is a medical specialty. The basis of medicine is to make an accurate diagnosis. In this case, the fillers had infiltrated all the layers of the lower eyelid and cheek junction. Fibrous capsule around the filler changes the anatomy and cannot be evenly dissolved after time has passed. Fillers cause an inevitable and lasting footprint on the tissues.
Jonathan sees many patients with complex eyelid and cheek problems, resulting from previous treatments and other causes. In each case the principles of medicine apply - to make a diagnosis and come up with the appropriate treatment.
The correct surgery at the correct time - will deliver the correct result.
Dynamic blepharoplasty surgery with the’ Twilight technique’ allows conscious and comfortable surgery for the patient, lining up all the dynamic creases of the face in all positions of eyelid and facial movement - natural results in 3-D, 4D (movement) and 5D (time).
