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This 33 year old lady from Pittsburgh presented to my office with a complaint of early tear trough deformity. Some patients develop a mild tear trough deformity (often referred to as dark circles under the eyes) relatively early in life, while others only really see the problem in their tear trough area after they have lost a fair amount of fat from under the eyes. Even through this patient’s tear trough deformity was fairly modest, it still bothered her quite a bit. I injected Restylane® with a thin microcannula (rather than with a sharp needle) and she was very pleased with the result.