What are my option to get rid of deep under eye creases/bags? (Photo)

Thank you for your question and sharing your photo. Based on the photo it appears as though you have a prominent eye bag that is accentuating the deep trough trough below.  There are surgical and non-surgical options for this.  Lower Blepharoplasty is a surgical procedure where the fat pad is removed from under the eye and in some cases transpositioned to the hollow area below.  Being that you are only 25 years old, perhaps a non-surgical approach would be more appropriate. Injecting filler directly below the eye bag into the tear trough will blend the area and give you a more youthful appearance. 

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.
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There are both surgical and nonsurgical ways to improve lower eyelid bags and hollows (tear trough). Since you are only 25yr old, this is probably a genetic cause. Mostly likely your mother or father has the same thing. To improve, but not completely fix, fillers can be injected into the hollow area to smooth out the transition between the bag and the hollow. This is relatively inexpensive and done in the office. The only way to completely fix is to have surgical correction. Since you are only 25, the fat can be removed from inside your eye, and a small amount of fat placed in the hollow will give you a nice result. Regardless, make sure you see a board certified, experienced surgeon.

Dear Nagelo,In some families, these lower lid bags due to prolapsing orbital fat present in the teenage years. There are not topical creams that work well. Best would be surgery and seeing an Oculoplastic Specialist in your area would be helpful to completely evaluate your condition and discuss options.I hope this was helpful.  

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

It is hard to tell from a single photo, but it looks like you have excess fatty tissue under your eyes. This is best treated with lower blepharoplasty surgery. In patients in their 20s and 30s who are not ready for surgery, fillers can sometimes be used to camouflage the bags. You would need an in person consultation to determine which procedure would be best for you.

You may want to begin by a combination of treatments, that while not permanent, may help.  Fillers are used commonly to help disguise irregularities under the eye.  Lasers, chemical peels, and microneedlling (Skin Pen) can help with tone and texture.  The use of medical grade skin products may help, but likely won't correct the issue.  Also, remember to always use sunscreen.  The only permanent treatment is surgery.  The one used to address your concerns is called a lower blepharoplasty.

Thank you for your question. You submitted a single photo, state you’re 25, and always had under eye bags, so you’re looking for a way to address these issues. You’re asking about creams and other options.
I can give you my perspective as a specialist. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I’ve dealt with a lot of patients with exactly this type of situation. Under eye bags is probably the most common surgical procedure we perform in our practice.
It is extremely common for a person like yourself to say they’ve always had under eye bags. In fact, people who come to me in their 30s and 40s will say that they’ve had under eye bags since their teens. So what is the best way to treat these under eye bags?
In the past several years, the options have become using a filler versus doing something surgical, and I perform both in my practice. Fillers are perceived as less invasive, but you’re still going through the skin, so in my mind it’s no different from surgery. Fillers can be effective in softening the transition between the deep area of the tear trough relative to the under eye bag.
With eye bags, it’s important to understand the anatomy to understand the principles of the solutions. Under eye bags represent lower eyelid fat prolapse, meaning the forward movement or shifting of fat that’s under the eyes. This is something you’ve always had, so it’s not age-related, but anatomic. The solutions are either soften the appearance, or surgically reduce the fat pockets.
At 25, you may feel you’re too young for this procedure. The reality is there are plenty of patients I have operated on your age and younger. The problem is significant enough for an intervention. In my opinion, it is less practical for a 25-year-old to keep going to a doctor’s office to keep getting injectables if there is an alternative long-term, more definitive solution. Based on just the photo and not a physical examination, I would lean towards a surgical procedure called transconjunctival blepharoplasty. That means under local anesthesia with LITE™ sedation, I would address the fat pockets from the inside of the eyelid. I would reduce, dissect, remove, as well as reposition as appropriate so you look as if you never had the under eye bags. This procedure works very well and can last a very long time, particularly when you do it this young in your life. It will more definitively deal with the anatomy of your issue.
Now something to, as a side note, a lot of times when people have this type of issue, they also happen to have relative hollowing of the cheek area and it’s something that I point out and it’s not hollowing in terms of aging but more of hollowing just as a matter of anatomy.  I also discuss the options of augmentation of these areas, but it does bring us back to considering fillers and other things.
Often with the lower eyelid blepharoplasty, I will combine PRP to help improve skin quality and discolorations, and maybe improve some volume in this area. PRP is platelet-rich plasma which is derived from your own blood, which is routine for us to do this at the same time as the procedure to maximize the aesthetic outcome as we’re taking away the fat pockets, but also improving skin quality.
Often, I suggest to my patients is do the procedure, then see how you look afterwards. If anything draws your attention, then we can consider procedures to help further maximize your appearance. Based on this photo, I would lean towards lower eyelid blepharoplasty. In our practice, we perform these procedures in a Joint Commission certified facility, which is the same certifying body that certifies hospitals and surgery centers. We’re able to provide the safety and the standards of quality, but at the same time, do it at the office setting under local anesthesia with LITE™ sedation.
I think it’s important for you to meet with qualified, experienced cosmetic surgeons. Look at their results and level of experience doing this type of procedure. If you like the outcomes, I think you’re more likely to get what you want with that approach. Again, a physical exam is very important to make a definitive recommendation. I hope that was helpful, I wish you the best of luck and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

There are a multiple reasons people get dark circles underneath their eyes, including genetics, lower eyelid position, lower eyelid bags, allergens, sun exposure, previous trauma, and loss of volume in the cheeks. Identifying the underlying cause is the most important and effective way to treat them.
About 50% of the patients that see me for eye rejuvenation will not need surgery and they will benefit from minimally invasive procedures such as volume restoration (dermal fillers), this is often more appropriate for younger patients however is not a permanent solution.
A more permanent solution would be a Transconjunctival Lower lid Blepharoplasty which involves making the incision behind the eyelid. This is the most ideal procedure for younger patients or those with very little redundant skin on the lower eyelid.

The bulge under your eyes is caused by herniation of the lower eyelid fat.  The most definitive treatment is a lower eyelid blepharoplasty.  This can be performed through a small incision from the inner lower eyelid (transconjunctival blepharoplasty), leaving no visible scar.  In some cases, the bulges can be camouflaged with dermal filler to the area.  This is a temporary solution and would require repeated treatment.  See a specialist to learn more.