Under Eye Bag Treatment? What is my best course of action? (Photo)

I have tear trough deformity, loss of orbital fat, and a pretty big visible vein. NOW- I also have wrinkles directly under the eye. I've been told my dark circles are hereditary and not a result of allergies, lifestyle, or irritation. I use sun protection every single day along with a retinol eye cream. What is my best course of action? A local doctor has suggested PRP as the skin is very thin and delicate and he was hesitant about filling with filler or lasering the area.

Doctor Answers 5

Under eye treatment

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You would benefit from a combination approach.  Fillers can be used to help with the hollow areas.  Laser treatments or microneedling (Skin Pen) can be combined with the fillers for a more complete look.  I would recommend working with a doctor who is experienced with injecting and treating this area.

Houston Plastic Surgeon
4.9 out of 5 stars 36 reviews

Under eye dark circles

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The best option for you is likely filler injection to fill the hollow area under eyes which are causing the dark circles appearance. See following video and link. If you did have true fat bags under eyes, then lower blepharoplasty with fat repositioning may be appropriate. Best to see an oculoplastic specialist.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

A combination approach for under eye bags/wrinkles--fillers, lasers, microneedling/prp, prp

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A combination approach would be best. Fillers, lasers, and microneedling/PRP can improve under eye bags and wrinkles. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Dark circles under eyes

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Hello and thanks for your question, 

If you've been evaluated for allergies and it's been concluded that you don't have any- that's a great start!

PRP is an option here although I don't do that in my practice, I would like to see some filler in your tear troughs. Properly placed filler will not cause a problem in your tear trough area. It's subtle and will give you some fullness there. 

As for the vein  - laser and or cautery or excision is your best bet there- I can't tell exactly how big the vein is from the picture. 

Hope this helps and God Bless!

Dr. Robb


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so I agree you have tear trough deformity which hollows out your eyes. You seem young in the pictures to me but correct me if I am wrong. I think that replacement of the upper malar volume will rejuvenate your midface and can be titrated to suit what look you want. I suggest 1.1.5ml of filler in each malar area to start with and then see how that looks.

Hope that helps.

Adam Goodwin

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