Solutions for bad tear troughs, saggy eyes or puffy/fatty pockets?

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 
Recommended Creams: Melarase Brightening Kit
MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Hello and thank you for your question.  Under eye hollows can not only be caused by aging (which doesn't seem to be the case for you) or from genetics and are very common! From your photos, it seems that you will benefit from a non-surgical under eye treatment.  With fillers such as Juvederm, Belotero or Restylane, areas that have lost fat and are hollow can be treated with great results.  The procedure is quick and easy with little downtime and results tend to last longer than a year in most cases.  I suggest seeing an injection specialist with lots of experience and have an in-person consultation to answer all your questions and concerns. Best of luck!

The under eye area can be addressed with filler injections or with surgery. Surgery is generally best for puffiness which might be age-related or genetic. In younger patients, filler injections are what I recommend most commonly and can be used to decrease hollowness under the eyes.
Be sure to see an expert who can review all of the surgical and non-surgical options with you in detail during an in-person exam and consultation.
All the best,

I would expect that you will get many responses suggesting a range of treatments. In young patients like yourself, the best option is filler injections. Although you dont feel there are hollows, there is excavation at the bottom of the bags that can be addressed with filler injections very effectively. I would definitely avoid surgery, prp, needling etc. Surgery is excessive and PRP/needling won't work for you.Best of luck for your treatment.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. 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

This is a common concern. Typically this can be corrected with either injectable fillers or surgery. Injectable fillers have the advantage of being done in the office with minimal downtime. Surgery offers the advantage of long term correction, but does require a trip to the or and more recovery. I would recommend consulting with a surgeon who regularly does these procedures to explore your options-Hope that helps!

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. Lasers can be used in combination to give improvement. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Hello, and thank you for the question. There are several minimally invasive solutions to your aesthetic concerns. Dermal fillers injected into the tear trough and upper check area to replace lost volume can leave you looking refreshed and rejuvenated. Many times, simply replacing volume in these areas is enough to restore a more youthful appearance. Voluma works very well in the cheek area, whereas Restylane Silk and Volbella work well to fill in the tear troughs.

Fillers may be a good choice for you.  They add volume and hide contour irregularities under the eye.  The treatment is done in the office and the results last up to one year.  See an expert injector in your area for a consultation to determine if this is the best treatment for you.

thanks for asking Dr Daniel Nan

You are a good looking women but you don’t like these tear trough. The common deficiency in fat appears both to the tear trough and the temples. It is probably a familiar trait you have and I woul say it is not difficult to remedy.  
Small amount of your own fat can be collected under local anesthesia and reinfected to both tear trough and temples. You will witness great improvement using your own resources !!