Advice for hollow undereyes/tear troughs? Age 27, male (Photo)

Question

I've spoken to two surgeons about this so far. The first recommended transconjunctival lower blepharoplasty and the second recommended filler but I would prefer a permanent solution. After my consultations, I became aware of fat grafting which I'm wondering might be a better solution? The second surgeon also mentioned risks with bleph that the fat might be visible through the thin skin, which the first surgeon didn't mention, so I'm unsure whether that is even a good idea.

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Camille Cash, MD · Answer

Filler is a great choice to add volume to the under eye.  While it is not permanent, it is more predictable than fat grafting and less involved.  The treatment is done in the office with at least partial results seen right away.  The product lasts approximately one year and is dissolvable if you are unhappy with the results.

Paul Charlson, MBBS · Answer

You look like a patient who might do well with some dermal filler.It's easy to perform if you are experienced and can last one to two years

Leonard Grossman, MD · Answer

The frontal view of your eyes is not sufficient to determine if you need anything done at all. But based on the pictures you submitted, I can tell you with certainty that you do not need a blepharoplasty. I discourage my patients from receiving fillers in the lower eyelids and preferred to use the patients own fat. You must, however, find a plastic surgeon, who is an expert in fat grafting techniques, with which you can have a natural and a permanent result. I hope to sub, so good luck from New York City Plastic Surgery.

Advice for hollow undereyes/tear troughs? Age 27, male (Photo)

Answers (4)

Answer: Treating hollow lower eyelids

Answer: Treating hollow lower eyelids

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Advice for hollow undereyes/tear troughs? Age 27, male (Photo)

Answers (4)

Answer: Treating hollow lower eyelids

Answer: Treating hollow lower eyelids

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.