What is the best treatment option for my under eyes? 32 y/o (photos)

I would move fat from the lower lid into the hollow area beneath your eyelid. This would help reduce the puffiness. The entire thing is a quick outpatient procedure and could be done through the inside of your eyelids (no external incisions or stitches). Filler could help in the short term though.

Your skin's natural plumpness and youthful appearance can definitely be an asset, but I understand how persistent puffy eye bags and lines can be frustrating. While lower blepharoplasty is a common solution for addressing these concerns, there are also non-surgical options to consider. Treatments like fillers can are most effective at restoring volume in the mid-face, while treatments like endolift offers a minimally invasive way to tighten the skin. Additionally, resurfacing treatments like laser therapy or chemical peels can improve overall skin texture and elasticity. It’s important to consult with a qualified professional who can evaluate your specific needs and recommend the best approach tailored to your skin type and concerns.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) 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, lasers, microneedling/PRP, cosmelan peels, 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

From the photos, there appears to be significant volume deficit in the upper cheek region accounting in large part for the bags and tear troughs seen (since the upper cheek region is a major support for the under-eyes). An appropriate volumizing filler properly injected into the upper cheek region will not only create a more youthful mid-face, but also diminish the infraorbital bags and tear troughs and even likely improve somewhat the deep smile lines below. You would be wise to consult with a board certified cosmetic dermatologist and best of luck.

Based on your pictures, the only way to definitely and effectively treat this issue is through a lower blepharoplasty - which would remove excess skin and, where necessary, pockets of fat.

I hope this helps,
best of luck in your journey !

Thank you for sharing your photos! I would need to examine you in-person to best answer your question. Eyelid surgery has become one of my most popular procedures to remove the fat that is protruding in your lower eyelid area. I am able to do a transconjunctival approach meaning that there are no visible scars. Saggy and crepey excess skin can also be removed, if needed. You may also benefit from skin-tightening procedures like Thermage, which is a non-surgical technique that uses radiofrequency technology to stimulate collagen and tighten the skin under the eyes with no downtime. The use of certain topical creams can also be helpful to reduce the appearance of dark circles and puffiness around the eyes. I suggest making an appointment with a board-certified plastic surgeon experienced in surgical and non-surgical eyelid procedures.