I have dark lines from my eyes to my cheekbones (most prominent on left side; more eye puffiness on that side too). Solutions?

Thank you for sharing your photos. The area under eye area is a difficult area to treat due to how thin the skin is. A multi-treatment approach to this area is necessary. I would recommend a soft hyaluronic acid filler to carefully fill in this area and minimize any shadowing (which can also contribute to the dark circles). Laser treatments or micro needling to the skin with PRP can help promote collagen formation and strengthen and thicken the skin. Finally good skin care products can help with any sun spots or uneven skin tones. Consultation with a board certified plastic surgeon is recommended. Best wishes!

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Thank you for your question and the pictures you provided.  There is not an easy solution that is 100% effective for the issues you are experiencing.  The only way to fully assess what is your best option would be to evaluate you in person so my recommendation is for you to see a plastic surgeon to develop a treatment plan together.  From what I can see, I believe that you would benefit from 1) skin care to address the hyperpigmentation and fine lines 2) lower blepharoplasty to remove/reposition the fat in your lower eyelids, and MAYBE 3) filler to add volume to your cheek and smooth the transition from the eyelids to the cheek. This would only be advised if the "line" or "tear trough" persisted following eyelid surgery. Not everyone is a good candidate for this treatment so please see a Board Certified or Board Eligible Plastic Surgeon to evaluate if you may benefit. Good luck!

This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional.  You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. 

From your pictures your under eye area looks "puffy" which may be from your reported allergies. It could use some filler to disguise and possibly some Hydroquinone if the darkness appears to be pigmentation on physical exam. I would suggest that you see a Dermatologist who specializes in allergies first, then an under eye expert for further evaluation. Best Wishes, Maurice Vick MD

Thanks for your question. A combination therapy is always more effective. For the volume loss of the tear through a soft filler can be very helpful . A combination of PRP and microbneedle or laser treatments is improving the thickness of the skin . A proper skin regimen is also very important. I highly recommend to see an expert  physician for consult.

There are several excellent options for rejuvenating the eyes, and a proper physical exam is necessary to determine which treatment is best for you. The skin beneath the eyes is very thin and gets even thinner with age. Blood vessels and muscles beneath the eyes may appear as dark circles. There may also be an indentation (the tear trough) which creates a shadow. That shadow is intensified if "bags" of fat have formed under the eye, creating greater contrast between the areas of light and shadow.I think you would benefit from a good skin regimen which includes hydroquinone treat the hyperpigmentation areas. Retinoic acid is also great for treating fine lines/wrinkles and brown spots.
In addition to a good daily skin regimen, you may benefit from Restylane soft tissue filler to fill in the indentations and minimize the appearance of bags and shadows under the eyes. Using an injectable soft tissue filler is a minimally invasive option that may delay surgical treatment for years. The amount of filler required to treat the tear trough area varies from person to person but most patients, and may require 1 or more treatments to get your optimal result. I recommend an in person consultation with a facial plastic surgeon.