27 - hollowness/pigmentation. Best treatment for under eyes? (Photos)

A quick and easy way to address general hollowness is with fillers and skin tightening procedures. Sculptra and Radiesse are oldie and goody products. But, there are others and it's best to have a comprehensive discussion with your doctor.

A full face frontal photo would have been very helpful for assessing the contribution of the upper cheeks (a major structural support for the under-eyes) to your infraorbital hollowness problem. If there is lack of support there, the choice of an appropriately robust HA volumizing filler for the upper cheeks would likely considerably diminish the problem by creating a smoother transition between the upper cheeks and the lower lid regions.
Note: the lack of success with prior filler treatments may have resulted from an improper choice of filler for the job and/or inappropriate placement of the filler, or even from simply not injecting enough a correct filler.
For addressing the pigment problem, a combination of the use of a series of in-office superficial peels (such as high concentrations of alpha or beta hydroxyacids, Jessner's Solution or low concentrations of TCA) and the at-home daily application of Rx prescription topicals, such as alpha hydroxyacids and retinoids, can prove very helpful.
You would be wise to make certain to consult with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Addressing hollowness and pigmentation under the eyes can be challenging, but there are several treatment options that may help improve these concerns:

Dermal Fillers: While you mentioned that tear trough fillers did not make a noticeable difference, it might be worth discussing with your dermatologist whether a different type or technique of filler could yield better results. Sometimes, adjusting the placement can make a significant difference.

Chemical Peels: Mild chemical peels can help improve pigmentation issues by exfoliating the top layers of skin and promoting new skin growth. However, these should be performed by a professional, especially in delicate areas like under the eyes.

Laser Treatments: Lasers, such as fractional laser therapy or intense pulsed light (IPL), can be effective for both pigmentation and skin texture. They help stimulate collagen production and improve skin tone.

Microneedling: This procedure can help with skin texture and reducing pigmentation by promoting collagen production. It can be particularly effective when combined with platelet-rich plasma (PRP).

Topical Treatments: Products containing ingredients like retinol, vitamin C, or peptides can help improve the appearance of pigmentation and skin texture over time. Consistent use is key for seeing results.

Consultation with a Specialist: Given your experience with fillers and the complexity of treating both hollowness and pigmentation, consulting a dermatologist or cosmetic surgeon who specializes in under-eye treatments can provide personalized recommendations.

It's important to discuss all potential treatments with a qualified specialist to determine the most suitable approach for your specific concerns and skin type.

Thank you for sharing your concerns. Based on your description and photos, I can understand your frustration with the darkening and hollow appearance of your under-eye area. These features can sometimes create a tired look and are often influenced by factors such as genetics, pigmentation, and structural anatomy.
To determine the best course of action, I recommend starting with a comprehensive consultation, including a Visia scan and physical examination, to accurately diagnose the root causes of your concerns. From there, we can create a tailored treatment plan, which might include the following options:
- Tailored skincare: Products like Alastin Restorative Eye Cream or Sesderma KVit can help improve skin quality and address pigmentation. - Biostimulation with PRF (Platelet-Rich Fibrin): This helps regenerate and rejuvenate the under-eye area naturally. - IPL (Intense Pulsed Light): Effective for treating pigmentation caused by sun exposure or vascular issues. - SylfirmX with exosomes: A great option for targeting vascular and pigmented components while improving skin texture. - Specific fillers: Using fillers like Restylane Lyft or Eyelight, placed deeply and precisely, can restore volume and reduce the hollow appearance.
My approach emphasizes not only providing immediate results but also ensuring long-term improvement and rejuvenation of the under-eye area. With a combination of these treatments, we can address both pigmentation and volume loss to achieve a refreshed and natural look.
Let me know if you’d like to schedule a consultation to get started!
Best regards,

You will have the best result from a combination of treatments. HA fillers are a great tool to improve hollowness in the tear trough area. You mentioned you have tried this in the past. Did you return to your injector for an evaluation? Perhaps more product was needed. An assessment by an aesthetician is encouraged to give specific treatment recommendations to even the skin tone. We always recommend using medical grade skin care products like Transform MD and wearing sunscreen every day to help keep skin looking healthy.