Could a midface lift raise up my cheeks and improve the dark circles under my eyes? (Photo)

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.

Thank you for your question.It is difficult to make an exact determination through pictures. Based on your photo, you may benefit from facial fat grafting. I would recommend an in person consultation to discuss all of your options.

Here are your best options based on your photos, which are not a substitute for a detailed in person consultation:1) Under eye fillers to smooth the transition from the lower eyelid and the top of the cheek. This approach is not permanent but does not require surgery. It is a fussy office service and it can be challenging to find the right injector. I know because I see many patients who fly into Los Angeles from Chicago to get under eye fillers. 2) Transconjunctival lower eyelid surgery with arcus marginalis release. This transfers some of the orbital fat in your lower eyelid to the top of your cheek. This is surgery and requires about 10 days of down time. Do not let well meaning surgeon insert implants that you do not need or talk you into fat grafts that are like injecting scar tissue in the eyelid and midface. This is unfixable. 

You do not have evidence of significant midface descent.   A midface lift done well lifts the midface including cheeks without changing eyelid shape.   However in your case you would not see meaningful improvement because your cheeks are in normal position.   Fat grafting to the area can smooth the circles and give a long lasting g improvement, but experience with the procedure helps a great deal.  I have drone many hundreds over a 15-20 year period.

I am sorry to throw a wrench in your analysis.  This analysis by no means is a substitute for a real in-life consultation.  When I analyse the photo you have provided I really do not see any midface ptosis, or any significant volume loss.  If I had one thing I could do to rejuvenate your face, I would do a brow lift and open up your eyes.  I think it would make you look more rejuvenated and lighter.

A volume deficiency can not be improved by trying to lift tissues into it. The requires the placement of volume in which their can be a debate between fat grafting or the placement of infraorbital implants. Each lower eyelid hollow treatment technique has their own advantages and disadvantages.

The recurrent circles under the eyes are caused by residual bulging lower lid fat.This could easily be improved by a transconjunctival (meaning the incision is on the inside of the lower lid and avoids a skin incision) reduction of the lower eyelid fat excess, which will create a small concavity at the top of the cheek defining the lid above.This is not major surgery and not infrequently required following the initial lower lid surg, to have the correct amount of fat reduction.I cannot help offering a suggestion for your consideration. Correcting the heaviness of your upper lids would brighten your appearance significantly and give the illusion of having subtly higher eyebrows, this is, of course provided the upper lid surgery is done with correct expertise