I'm 21 and want my eyes to look less tired. Options? (photo)

It's difficult to assess whether and to what degree volume lloss in the cheeks is contributing to the under eye issues. But, if there is, as I suspect, this can be quickly and easily remedied with the use of a lifting filler, such as Restylane Lyft, in the upper outer cheek regions,, which would not only create a more feminine, heart-shaped face, but secondarily improve the under eye issues. Belotero Balance could be used subsequently should the inftraorbital tear troughs and bags still remain an issue. Finally, microdroplets of Botox placed at the tails of the eyebrows may just give the little lift required there. You would be wise to consider consulting with a board certified cosmetic dermatologist before jumping to the aggressive, invasive and expensive surgical option.

I believe that PRF PRO to the under eyes would be a good temporary and non-invasive procedure to help with lessening the appearance of hollowing in the under eyes. This result can last around 3-4 months, however, results vary. Notably, this will give you a chance to determine if you like the aesthetic of having your under eyes filled.

As for your eyebrows, I would recommend either of the following treatments. The first one is a temporary and non-invasive option that involves a few injections of neurotoxin to the tail of brows to help achieve the “brow lift” effect. If you would prefer a more permanent option, then I believe you would be a great candidate for an endoscopic brow lift. This procedure will help open the eye area without looking too “over done.” Please note that this is still a surgery and does entail sutures within the hairline to help anchor the brows. The sutures are removed after 10 days and most of the bruising has subsided by then. Swelling can last up to about 2 weeks and pain is manageable through the use of ice packs and Tylenol. Going forward, I would recommend you to complete multiple in office consultations with board certified facial plastic surgeons to discuss your aesthetic goals. This way, they can better assess your face and create an ideal treatment plan for you. Best of luck, Kian Karimi MD, FACS

Fat grafting to the hollows of the lower eyelid with Co2 laser resurfacing would provide a beautiful result. Fat grafting to the tear troughs may also help. I do believe that you would benefit from a conservative browlift.

Lower eyelid dark circles are affected by volume loss (with or without fat bags), thin skin, and hyperpigmentation. From the photos you have provided, it looks like volume loss is a big factor for you and you may benefit from hyaluronic acid (HA) filler injections to the area. HA comes in different varieties and it is important that the product you use does not absorb too much water, otherwise the filler can create an overly-swollen look.

Options include filler or surgery to fill in the tear trough. Surgery would involve moving your natural eyelid fat to fill the tear trough. Best to see an eyelid expert in your area.

Thank you for posting your photos with your interesting question. It appears that you have lower eyelid hollowness that can be corrected by adding a hyaluronic acid filler like Restylane or Belatero. This should be done by an injector experienced with under eye filler because it is not a beginner injection technique. It will give a natural and rested appearances and usually lasts up to 1 year. Best wishes, Richard Wellington Swift, M.D., F.A.C.S