Thank you for sharing your question and posting your photos. Only surgery or injection of dermal fillers will correct your problem. It does not appear from the photo that PRP or lasers will correct the problem. You should be evaluated in person by an eyelid specialist who can give you proper guidance. Good luck,
Hello and thank you for posting your question and photos on RealSelf!
That being said, under eye solutions range from noninvasive peels and lasers to help tighten skin and improve texture all the way to surgical excision of skin and fat. Based on the photographs you posted, you may benefit from improving the quality of the skin as well as skin excision in the under eye area and fat grafting or repositioning of your lower lid/upper cheek area to improve the relationship between the 2 areas. I find that fillers typically do not correct the under eye shadows as much as we would like them to and most patients typically turn to surgical options after being unsatisfied with fillers in this particular area.
You would benefit from an in person assessment by a reputable board certified plastic surgeon.
Best of luck to you in reaching your goals!
We offer both microneedling and undereye fillers at my practice and for you I would definitely suggest fillers. We have many clients in their 20s who get their undereye bags corrected with fillers. Just like with micro needling or fat injections or even surgery, results are not permanent. There is a filler called Voluma, which is indicated to last up to 2 years and you would probably only need 1-2 syringes. At my practice in Ohio and NYC it is $799 a syringe.
The eyes are best treated with a combination approach of fillers, lasers, microneedling/PRP for improvement. Ultherapy/thermage, venus legacy all do well for swelling or puffiness. I would suggest consulting an expert. If surgery is an option they will recommend. Best, Dr. Emer
A single For someone who does not want the very best, most effective treatment we have for your issue, which is hyaluronic acid fillers, why on earth would you do an ineffective treatment that is only going to separate you from your money? The papers on this subject are highly flawed in my opinion and do not amount to science. A conservative filler treatment will last a year or more at a time. At some point, lower eyelid surgery will be an option for you. Regarding fat grafting, this fat is place in critical glide planes at the junction between the lower eyelid and the top of the cheek. Rather than making a beautiful result, what grafted fat is actually doing is causing scarring in the worst possible place. You do not like the way the eyelid heaps when you smile. I assure you, you will like it even less after you have healed from grafted fat.
See following link for details on transonjunctival lower blepharoplasty with fat repositioning, which can be done under local anesthesia.
Always tough to tell just from a photo, but when you smile you have a very deep tear trough. This indicates you need more volume here. Fillers are the easiest way to help this and can last for at least one year. Laser, microneedles and PRP are NOT going to fill in this area. They might help for fine lines and wrinkles, but would not give you the volume you need. Surgery with fat repositioning is an option too.