I have hollowness under my eyes, is there a permanent solution? (Photos)

Although filler injection is a great treatment to correct under eye hollowness, it is not permanent. Tear trough implant is a permanent option but more invasive. See following website link. Personal consultation is needed to discuss options.

Thank you for your question and the pictures. It would be useful to include your cheek in the picture also to see the whole of your mid-face region. This would help me to advise you appropriately. 
Apart from fillers, which you have eluded to not wanting to have, the other options are to either have fat injected into the area or to have a cheek lift if there is sufficient descent of underling tissue. These can give very nice results and are permanent solutions.
Fat transfer uses your own fat and so is safe. The fat is harvested through liposuction techniques and then a small amount is injected in a similar fashion to using hyaluronic acid filler. 
A cheek lift is carried out via a lower eyelid blepharoplasty incision and the underlying tissue is re-draped to reduce the hollowness/ sunken look and simultaneously lift the cheek. It would be helpful to see the cheek pictures also to determine if this is a solution for you. 
I hope this is helpful for you.
Best wishes
Kind regards 
Rohit Seth 
Plastic, reconstructive, aesthetic and hair transplant surgeon

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

The most common treatment for under eye hollows are dermal fillers.  If you seek a permanent solutions, tear trough implants versus permanent fillers may be considered.  See a specialist for a face to face consultation and comprehensive examination, and to become more educated about the various treatment options.  

Riverisland, thank you for the pictures upload. You have a classic tear trough deformity which shows a sunken appearance of the area underneath the eye terminating at the junction between the bone of the actual eye socket and the upper cheek. As we age, this area becomes progressively hallowed due to the sagging of the skin and fat along with muscle atrophy in the region. However, many also have a genetic component (inherent anatomy) to under eye hollowness, which is what we are seeing in your case.  
Volume restoration is the key to giving you the rested and youthful appearance you are looking for. Temporary options include fillers that last for varying lengths depending on the type and amount injected. It is vital to choose a filler that has an appropriate density so that it remains in place and does not dissipate within the area due to contraction of the muscle needed to close your eyes. Furthermore, certain fillers, if placed superficially, can lead to a Tyndall effect where a blue hue is seen on the skin. Permanent fillers also exist, but do carry a risk of reaction by the body seen even many years down the line. 
Other permanent options include fat grafting using autologous (self) or exogenous (outside) adipose tissue. However, fat grafting can, at times, lead to uneven contouring (e.g. lumpiness) if not performed correctly. Implants can also be placed along the tear trough, but can run the risk of infection, displacement, and extrusion if not appropriately placed. 
A permanent solution I believe would be best suited for you is called a suborbicuarlis oculi fat (SOOF) lift which involves a small surgery. Since you have a youthful upper cheek, the fat in this area can be re-positioned upwards to lay over the lower portion of the hallowing seen under the eyes allowing for a smoother transition from the cheek to lower eye lid. 
Ultimately, it is important to discuss all options with your surgeon to determine the best outcome for your desired look. I wish you all the best!!

If you are not interested in fillers, you may want to consider fat grafting for added volume.  I recommend visiting with an experienced plastic surgeon for this procedure.  Symmetry will be important, so you want to make sure you are confident in your surgeon.

For deep tear troughs, permanent options include longer lasting fillers as well as implants. There are newer techniques available to improve the hollowing including transposing of fat and cheek implants that could also be considered if the surgeon is familiar with these procedures.

Thanks for this question! The best option for a long lasting or even permanent treatment of undereye hollow is transconjunctival blepharoplasty with fat repositioning or autologous fat injection.  This can be best assessed in person during a dynamic consultation. While I understand the frustration with repeated treatments, I've gotten up to 2 years of a great result with Restylane filler in the tear troughs without the need for surgery. Because this area can be tricky with many important structures, I recommend going to someone trained extensively in eyelid anatomy. Hope that helps!

Without a photo it is difficult to give the best soloution but in general, dark circles without bags can be helped with a lower lid blepharoplasty and a mid face lift. If there are bags and circles, then a gag removal/ repositioning combined with a mid face lift would be a more permanent doloution than fillers. Make sure to see a board certified surgeon and the before and after correction photos. Plepharopkasty is an art and not every surgeon has the same view of perfect result !!

The best permanent correction of the depression that you see underneath your eyelids is a procedure called a trans-conjunctival blepharoplasty with arcus marginalis release and composite fat grafting.  To learn more please see below: