How to improve tired undereye hollows? (Photo)

Based on your photos, your eyelids are not in bad shape at all. However, you do have small fat pads that can be reduced, and the crease underneath of that can be filled with a fat transfer, creating a nice, natural long term result. Be sure to see a facial specialist for consulatation.

You would benefit from a lower blepharoplasty with fat transposition.

Best Wishes,

Gary Horndeski, M.D.

Regard, please re-asking a question with photographs. Sometimes we can fill under eye grooves, and sometimes it is better to remove the fat pads. Thank you for this question and I hope it's helpful. Sincerely, Dr Joseph

You seem to have a condition which is referred to as hypertropic orbicularis. The orbicularis muscle it is used primary in eyelid closure and blinking. The upper portion of your orbicularis in your lower eyelids have become larged and therefore it gives a role to appearance. This may often be mistaken for excess fat while it is redundant muscles. A traditional blepharoplasty surgery will not resolve this issue..
The simplest way to address your hypertrophic orbicularis is with Botox injection to minimize the muscle contracture which would help to decrease its hypertrophic appearance. This must be done by someone who have extensive experience treating this condition.
In severe case surgical option may be viable in which some of the muscle is resected out. One must be cautious, not to resect too much of the muscle because it may increase the chance of an ectropion. This will result in the eyelids turning outward. With proper technique, an ectropian can be avoided with excellent results.
The simple solution for your condition is just the use of Botox and you should see significant improvement in one to two weeks. You may need repeated treatments in the future to maintain the appearance of a smoother and flatter eyelid.

It is very likely that you have a mild malar hypoplasia, small cheek bones, what is the reason for early manifestation of your problem. Periorbital augmentation with fat grafts and trimming of the hypertrophic portion of orbicular muscle will bring more balance in periorbital areas. Good luck.

An in-person examination that allows for palpation and manipulation of the tissue is the ideal way to assess this issue. However, at least from the photos, the bulges under the eyes appear to be what we call "jelly rolls," because of their resemblance to the candy, but are in fact bulges of the under-eye muscles. If so, then the injection of a couple of microdroplets of Botox in the belly of each muscle can help to diminish these, and in so doing, would also make the hollow below less prominent and create a more gradual transition between the upper cheek and the infraorbital region. You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

These rolls are considered aesthetically desirable. You might find a surgeo to remove this. I am strongly advising you not to do this to yourself. Between this and the orbital rim is were herniated fat presents. You do not have any herniated fat. So do not get surgery for this. Do not get grafted fat for this. This area could benefit from hyaluronic acid filler to provide volume here. Please understand this can be a very fussy service. Know who you are going to.