Early 30s has started to develop dark circles under eyes, smile lines, sunken face. How to refresh? (photo)

Question

I've always had a narrow face, but recently feel like my face has started to look sunken and tired (I lost a bit of weight and also my skin has started to age as I'm in early 30's). I also have developed darker circles under my eyes and smile lines. I'd like to know what you recommend to refresh my look.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from fillers in your malar region and nasolabial folds.  You could also have fillers under your eyes.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Randal Haworth, MD, FACS · Answer

Thanks for your question. There are are variety of options when it comes to restoring lost volume to the face. These include fillers, either temporary or permanent, facial implants and fat grafting. They can create volume, symmetry, and balance your facial features. To address your concerns I would recommend having an in person consult with a board certified plastic surgeon who specializes in facial aesthetics and contouring.

Meegan Gruber, MD, PhD · Answer

Hi JZ! Fillers to the periorbital (around the eye) area can really help rejuvenate the eye area in a natural way. Temporary solutions include hyaluronic acid fillers (Juvederm, Voluma, Resytlane) and more permanent solutions include fat grafting and small silicone implants. Find a great board-certified Plastic Surgeon who understands your goals and with whom you can communicate well! Good luck on your journey toward a more refreshed look. 
All the best, 
Dr. Meegan Gruber

Thomas A. Pane, MD · Answer

Some combination of filler is going to be best here.  It has to be done carefully especially in the orbital area.  A fat transfer may work best as you can treat all these areas.  But if you don't want surgery you can have fillers done.  Two types are needed in most cases for your situation.

Edward Buckingham, MD · Answer

I would echo previous posts in that your major issue is volume deficiency, especially in your midface.  Fillers are an excellent option for volume rejuvenation.  They can be safely and effectively used for all of the areas you are concerned with (cheeks, infraorbital hollows, nasolabial folds, etc).  Fillers can differ in their viscosity and longevity.  Speaking with an experienced surgeon will allow you to figure out which filler is best for you.  For a longer lasting, more permanent solution, you could consider fat transfer as well.  Good luck.

John J. Martin, Jr., MD · Answer

Some HA filler would be helpful for the hollow under eye.  For the thin face should consider some fillers or fat.

Jason Emer, MD · Answer

A combination approach would give the most improvement. I recommend a combination of Botox and fillers for under the eyes, fine lines and to create volume with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Michelle Copeland, MD, DMD · Answer

One “refreshing” option may be the liquid facelift. Advanced techniques gently lift and contour facial features without surgery and little downtime. Fillers such as Juvederm, Radiesse, Sculptra, and even your own fat can lift your skin and recontour your face restoring a more youthful appearance. Topical creams non-ablative laser treatments can also help rejuvenate your skin. Thermage may also be an effective treatment for tightening the skin and giving you a refreshed look. I suggest making an appointment with a board certified plastic surgeon for consultation to discuss your options.

Steven Wallach, MD · Answer

Judicious use of fillers sounds like it would be a good choice for you.  This would help the sunken cheeks, the nasolabial folds, and the depressions by your eyes.

Robert Brueck, MD · Answer

After looking at your photos I would think some microneedling perhaps a good skin care regimen.Also add some fat to your face to fill it out.One also might consider some light peels around your eyes.

Early 30s has started to develop dark circles under eyes, smile lines, sunken face. How to refresh? (photo)

Answers (11)

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