38 with premature aging. I've got eye bags, sunken eyes, facial fat loss and prominent wrinkles around eyes. Options? (Photos)

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 

Recommended Creams: Melarase Brightening Kit

MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 

Dr. Karamanoukian

Realself100 Surgeon

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

Under eye bags and hollows can be permanently corrected with surgery or temporarily camouflaged with fillers.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. Cost will vary and can be discussed at your consultation.
I hope this helps!

I understand what you don’t want, but if you want to ask a question you should listen to the answers. For you, wrinkles around the eyes are best treated with Botox. Dysport can also be used for that problem.  Your pictures are not clear but if you have bags under your eyes with a depression ,you may need to use a filler such as a Hyaluronic acid such as  Restylane,Voluma or Juvederm.If however this would not help, you may require surgery. This can be done without outside incisions with a trans conjunctival blepharoplasty. Obviously you have to make a choice but if you don’t like your aging look these are great options with minimal to no downside when done with a board certified facial plastic surgeon, plastic surgeon or dermatologist.

Hi there. Unfortunately I don't believe you will get much in the way of results without some noninvasive procedures. Your skin may improve with a good medical grade pigmentation system. Your eyes will probably not benefit from any creams or lotions. I would start with some Botox for the crows feet, and your age is a normal age to start it. Hope this helps, Dr. Sawyer