34, I have hated the way my under-eyes look for a long time. What procedure is recommended for the best results? (Photos)

Question

Hi there! I am 34 years old. My under eyes have always looked like this - and I hate it. I'm trying to figure out what is best for me. I have had two consultations so far and both surgeons said different things. Consult 1: Fat grafting only Consut 2: Lower (could also do upper) bleph + fat grafting I am in the process of getting a 3rd consult from a doctor in Raleigh (Dr. Mettu) who does NOT do fat grafting/repositioning - only blephroplasty. I'm trying really hard to educate myself on everything...what the root of the issue is, what is going to give me the best, SAFEST, long-term results. I'm so overwhelmed with the options, approaches, etc. There is also a doctor in Charlotte who does what I've learned to be called a 'SOOF' lift...so I'm trying to weigh that option, too. I've read about the cons of fat repositioning and grafting (unreliable + unpredictable) and I'm hesitant about just going the fillers route. If I'm going to fix this, I just want to fix it. I don't want to do anything too dramatic or ruin my face. THANK YOU!

Young Min Im, MD, PHD · Answer

A Comprehensive Solution for Under-Eye Hollowness and Bulging
If we were to identify the thinnest skin on the face, it would be the under-eye area. The skin beneath the eyes is extremely thin and delicate.
Based on your photos, I can see both hollowness and bulging in the under-eye area. If we simply add volume at this stage, whether with filler or fat grafting, the bulging may become even more prominent and the under-eye area could appear heavier.
Most importantly, the hollowness is related to the development of the tear trough. The key point is to release the tethering of the tear trough rather than simply adding volume.
Based on your photos, I would recommend lower blepharoplasty. This procedure can reposition the fat located above the tear trough while also tightening the skin, helping to improve the tired and aged appearance of the under-eye area and creating a smoother, more refreshed look.
The recovery period is relatively short compared to many other facial rejuvenation procedures, and I believe you will be very satisfied with the level of improvement after surgery.

34, I have hated the way my under-eyes look for a long time. What procedure is recommended for the best results? (Photos)

Answers (1)

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