Under eye bags since birth. Wondering if it's birth defect (obviously) and what I could do? (photo)

The area under the eye that concerns you is likely a genetic issue.  You may wish to try fillers in the area.  They disguise irregularities can help to smooth the under eye.  I recommend visiting with an experienced injector in your area to learn more.

Hi and thank you for your question! Bags and dark circles under eyes could be present in people of all ages. Based on your picture, the bags and dark circles can be effectively treated with injection of hyaluronic acid fillers such as Belotero, Restylane or Volbella. I recommend micro-cannula technique for better results. Please make sure to work with a highly experienced cosmetic doctor for best results. I hope it helps and good luck! 

Thank you for your question.  Based on your photo, I think you would benefit from a transconjunctival blepharoplasty to remove the fat bags through an incision on the inside of your eyelid.  Best to speak to a board certified plastic surgeon.  All the best, 

Hi MRodd.  You are a perfect candidate for Restylane or Juvederm under the eyes.  Young patients like you with very firm skin under the eyes have excellent results with fillers and you can see similar results at the link below.  

A short term partial treatment would be filler injection the hollow dark area under your eyes. A long term treatment would be transconjunctival lower blepharoplasty with fat bags repositioning. See following surgical video and link.