Fillers or Surgery for This Underye Issue? (photo)

I'm a woman in my mid-twenties and have always "suffered" from this undereye issue that i've had. It's clear in photos and in person that I always have a bit of a tired appearance and the skin under my eyes is very saggy. It's not the best look for a working person! I'd say it started being noticeable when I was 11-12 yrs old so I know it's most likely my facial structure/heredity. Would fillers or surgery be a better solution for me? I've included a photo and both sides are about the same.

Doctor Answers 3

Undereye Sagging

 It is difficult to tell from the photo but it appears to me that you have a "bulge" on your cheek, not a depression. This is called a festoon and represents a fluid accumulation. These are difficult to treat and a filler that is not paced correctly can actually cause more fluid accumulation superior to it . Festoons can be improved by re-suspending the eyelid and support structures to the bone lateral to your eye(s). You may not be find anybody willing to perform this surgery considering your age. At least a consideration is a make-up technique to minimize the appearance. You might also try TNS Recovery Complex which can offer some tightening for several hours after application.

Austin Dermatologic Surgeon
4.7 out of 5 stars 3 reviews

Please do not be confused, It is unethical to inject silicone oil as a filler.

Restylane is an excellent filler with a remarkable track record of safety.  This product would be very helpful for your concerns.  Find an experienced, ethical injector.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Injectable Filler treatments may be considered for improving midface depressions.

I read your concerns and reviewed your photo:

You appear to have a midface depression just below your malar (cheek) fat pad. I have had variable success in my attempts to improve this with Silikon-1000, an off-label filler for permanent results. Most patients may see some improvement, but these grooves are difficult to completely eradicate.

Hope this helps.

Dr. Joseph


Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 421 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.