I'm 25 years old and have double bags under my eyes. What treatment would you recommend? (photos)

Dear DoublebagsThank you for your question!  From your photo- the swelling and line seem to be from "malar edema" - the line along which the lymphatic outflow around your eyes- is a little backed up, causing the swelling.  This is not always easy to treat.  Fillers may soften this a little- but sometimes can make it worse.With Warm RegardsTrevor M Born MD

I would start with Belotero or Restylane for your tear trough. They don't absorb as much fluid as some of the other fillers and work great in that area. It's not uncommon to see this issue in younger patients. The problem is that you would have to repeat injections every 8-12 month. Once you have gain trust in your injectors abilities you could do something more permanent like fat transfer. 

Hi DB.  Not to worry, you are an EXCELLENT candidate for tear trough injections with Restylane.  In fact, our youngest patient for this procedure was very much like you.  She was only 18, but because of her genetics, the under eye area was very withdrawn (sunken) and darkened.  She had excellent results with Restylane and you will also - provided you find the right injector.  To find before and after pictures of Restylane under the eyes for our Orange County, CA patients, check the link below.

In
my view, the most important thing you can do is to find a board
certified plastic surgeon who is has significant expertise treating the
eye area and lots of tools to use. Finding a strategy that works for
you may involve trying more than one approach, so having a trusted
partner is important.
The
first step is an in-person exam. This will give your doctor more
information about what's happening beneath the skin. He or she may
recommend a filler to plump up the depression from underneath or fat
grafting. Another option may be repositioning the naturally-occurring
fat pads under your eyes. There may be other options as well.
In
addition to possibly trying more than one treatment, it could also be
that you go with one solution now and a different one later on. That's
another good reason for forming a partnership with a talented cosmetic
surgeon.

Just adding filler alone when there is significant puffiness or bagginess may just add to the volume and puffiness overall.  First, I would suggest testing to see if the bags shrink with a low dose of a diuretic pill prescribed by your physician, and if the puffiness does not fully resolve with this test, then you may also have a hereditary fat pad.  Such fat pads can be easily removed with a small laser incision on the inside of the lower eyelid.  I prefer this technique referred to as laser lower blepharoplasty.  There is less bruising, bleeding and swelling than when it is done with a scalpel.  In addition, a small amount of Botox is helpful for the small wrinkle and roll directly under the lash line.  Filler is helpful for any residual tear trough groove.