29 years old female, looking for permanent solutions for under eye hallows and lines. Options?

Another option for this area is facial fat grafting, which injects your own fat cells into the tear trough to add subtle volume and refresh the eyes. The results with fat tend to be much longer-lasting than what you see with filler. However, fat can also be less predictable, and there is no way to reverse it if you don't like the results. Make sure you work with a very experienced, facial plastic surgeon with the expertise to produce the best possible result for you.

Thank you very much for your answer, in your case I recommend performing a treatment in combination of techniques and technologies that allow us to object to a rejuvenation of the mada, in this case it would be botox to control the lines of expression of the ocular contour and perform a blepharoplasty to extract the bags of the lower eyelid.Blepharoplasty is a surgical procedure that aims to improve the aged appearance of the eyelids by removing fat bags and excess skin from them. It can be done in isolation or in combination with some other facial cosmetic surgery.In the consultation, the specialist assesses the individual characteristics of your eyelids, as well as their general condition.You are also informed about the usual preoperative rules about taking or suppressing medicines, tobacco, taking liquids and food.DuringBlepharoplasty is performed in the operating room, under general anesthesia, and usually lasts 1 to 3 hours.AfterThe eyelids will be swollen and bruises will appear that will resolve in a few days. You may notice alterations in your visual acuity, tearing, hypersensitivity to light during the first 2 or 3 weeks, you should wear sunglasses while the bruises persist.It is important to keep relative rest 2 or 3 days and avoid efforts for 1 month. You will be able to return to work in about 1 week or 10 days.RisksBlepharoplasty is a safe surgery and risks are minimized by following the surgeon's instructions.Among the minor complications that may occur are: blurred vision, edema or slight asymmetries in healing.ResultsThe scar in a few months will be practically invisible. The results after a blepharoplasty are favorable and last for years, in many cases, they are permanent. Bags don't usually reappear.

lower eyelid surgery can help long term but fillers, lasers and peels will be needed ongoing to keep the improvement.

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, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

The only real permanent treatment for under eye hollowness is infraorbital rim silicone implant. Need more detailed evaluation and discussion to determine if it appropriate for you.

For a more permanent solution to your concerns you can consider fat grafting. Fillers do a nice job of adding volume, but they are temporary. See a board certified plastic surgeon near you to discuss your options including fat transfer.

Fat grafting can be performed to the hollow areas below the eyes for a more long-term solution. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

A transconjunctival (inside the eyelid) incision can be done with the laser. Excess fat is removed and used as a graft.
The Arcus Marginalis is a small structure which holds the lower eyelid skin to the bone creating a depression, the dark circle. The loose eyelid skin hangs over the depression creating a shadow, the dark circle under the eye. After releasing this structure fat is placed over the bone plumping the dark circle