What can I do to fix my deep set or tear trough under eyes? It makes me look older (Photo)

Hi, thanks for the question.  You need a multifactorial approach to fix this.  Dermal fillers will help considerably, and we have fixed many folks like you.   As the previous physician mentioned, it is challenging.  But, with newer fillers and a cannula technique you can get good results.  You need a deep, thick filler first to give some robust volume and then a more superficial, light filler such as Restylane Refyne to blend it and make it look natural.  I wouldn't let anyone go into the tear trough directly with a needle. The risks are too high, and the results generally are less than desirable.  Also, a little Microneedling RF with something like Vivace will help stimulate some collagen production and skin tightening.  I would not attempt laser resurfacing due to your skin type.   Best of luck, Dr. Giordano

I would take it slow.  This area has very thin skin and the result can be good if you take your time.  You have some excellent suggestions that I agree with.  Namely, build it up from the bottom, wait and come back to refil.  It is a challenging area so be careful.

Hello,
Trying HA fillers, Belotero, Restylane Silk seems to be a reasonable approach.
I would recommend to start building it up gradually and in 2 sessions so it will not be overdone and cause more trouble. I am optimistic you would see some improvement.
 other options also available which potentially would help you. But I still think the filler is the best first step.
important to choose the right physician and the filler.
Good luck

Deep set tear troughs are very challenging to improve -- especially based on your particular anatomy. Many questions on this forum are answered quickly by many doctors - im not surprised that not a single other doctor has responded yet to your question. In 2017 we still have no perfect solution for this challenging problem. Tear trough or cheek implants were once tried but they look unnatural and have other problems and have been mostly abandoned. Blepharoplasty can not help you. Filler in the tear trough can be tried, but from your photos I think this would be difficult to achieve a natural, normal looking result -- but you could consider filler such as Restylane. Fat transfer is not something I perform and certainly does not last long in the tear trough at all -- but this could be considered, just not with me. I am sorry I cannot offer a better answer. Best wishes. Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

you are a perfect candidate for fillers in the tear trough area.  Several fillers are available and you experienced Dr should be able to choose the right one for your need.  The filler should raise the depressed area and give a rested and younger look.  Make sure a board certified Dr is doing the injection.