27 y/o, Do I have under eye bags or tear trough deformity? (photos)

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Thank you for your question. There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 
Recommended Creams: Melarase Brightening Kit
MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 
Dr. Karamanoukian
Realself100 Surgeon

You're beautiful!  It is hard to see exactly what is bugging you in these photos..but, the under eye area is a common area of complaint especially following weight loss.  Losing volume in the cheeks or hollowing of the tear troughs can lead to slight lengthening/deepening of the under eye region causing shadows and more visible vessel congestion.  Replacing this facial (cheek) volume with either fillers or sculptra can improve the under eyes and also a thin filler carefully and conservatively placed directly to the tear troughs can help. (These are common approaches but may not be the best approach for you based on your in-person evaluation).  These treatments should not be taken lightly as they can be dangerous if performed incorrectly without expertise/experience. 

You are hitting it right on the money with your descriptions.  A key fact to your question is that you are able to camoflauge this with good lighting or a flash. That helps us appreciate in the photos (nothing can replace a good physical exam with a facial analysis) that this is a shadow issue. With your description you likely are having an aspect of orbital fat protrusion with some mid medial facial fat loss. If you gained your weight back you would probably like your eyes more. I think fillers are likely a good option to help taper back that area of volume change! The alternative or second line in my approach would be possibly reducing your orbital fat but you are young and pretty. I would take a very conservative approach.Hope this helps.Best of luck,DrC

You do have lower eyelid bags - which is fat from around you eye that has come out onto the cheek.  You are young and it is likely that your bone structure in the cheek is flat and allows the fat to bulge out.  Although fillers can try to hide this, the only way to completely resolve the bags is surgery to remove the fat.  The can be done through the lower eyelid inside (transconjunctival) so no scars.  Many others have recommended filler and certainly you can try this first, but it will not completely resolve the issue and will need to be continually redone.  Hope that helps!Dr. Z

From the submitted photos, it appears that you have mild relative mid-face flattening.  Very likely you would benefit most from injections of Sculptra to the upper cheeks, or even a Vampire Facelift.  I would avoid the hyaluronic fillers in you due to the thin skin that takes on a bluish hue you mentioned. 
Reducing the lower lid fat pads surgically could improve the appearance for some years, but it would be temporary, due to the usual resorption of the mid-face bones.

The pictures really help! The majority of your issue could be addresses with well placed filler with some in cheek as well. At your age, fillers would be the answer.When you get older, and loose more fat under the skin, I could see how the fat pads under the eye may become more obvious. It that case a lower lid blepharoplasty would help but not now.

Fillers are a great choice for you.  The wonderful thing about this option is that it is reversible.  If you don't like the results the product can be dissolved.  Fillers are used to help disguise under eye irregularities.  Yours are mild, so fillers are a good choice.  Be sure to see an expert injector and discuss your goals for treatment.

Thank you for your question and photographs. We see this question in our office all the time. It's difficult to tell from photographs. I've seen patients with premature fat pads secondary to allergies or just being congenital in their early 20s. The diagnostic test is to push on the eyeball gently and see if a lump forms where the fat pads are. Typically, when you look worst from overhead lighting it's due to a protuberance of the fat pads casting a shadow onto the orbital rim. We see a lot of patients who have this deformity tried to be corrected with tear trough fillers. In my experience, even if done correctly, it looks like one big lump from the eyelid to the lid cheek junction. Some patients need both removal of fat and a buffering of the exposure of the orbital rim by placing fat grafts at the time of surgery below the muscle so as to reduce the height of the lid cheek junction. It's been my experience that if you're seen by a physician or nurse who lacks the ability to do eyelid surgery, you will end up with fillers. I would recommend you at least be seen in consultation by board-certified plastic surgeon or facial cosmetic surgeon for an assessment of whether a surgical endeavor might be your best bet. Hope that's helpful.