Tear trough filler or procedure for thin skin under eyes? I am a 35 yr male with pale thin skin. (photos)

Question

Hello I am a 35 yr male with pale thin skin. I have had this issue of looking tired even when I am well rested obviously more noticeable if I have a night out with friends. I've had this problem since my late 20's and I feel its getting worse. Overall I am relatively healthy about 6'1 185 lbs and in decent shape. I had a consultation with a well reviewed surgeon and told my skin was too thin back in 2016. Is there any hope for me? Any new recommendations/procedures for me?

Mehryar (Ray) Taban, MD, FACS · Answer

I usually recommend lower blepharoplasty (transconjunctival technique with repositioning of the eye fat bags to the hollow tear trough area) for long lasting improvement but need more detailed evaluation to determine.

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing photos along with your question. Based on these images, you do appear to have hollowing under the eyes. While an assessment of your skin is necessary to determine the best procedure or combination of procedures, there are several ways to rejuvenate the eye area.

Fillers, lasers, and other procedures that help collagen production can be very effective in refreshing the skin around the eyes. For a surgical option, there is facial fat transfer to restore volume under your eyes or lower blepharoplasty which eliminates excess skin or fat under the eyes to reduce the appearance of bags, puffiness, loose skin, or hollowness under the eyes. But the best way to determine the appropriate treatment is to schedule an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, determine your eligibility for any procedure, and ensure the best possible outcome.

James R. Gordon, MD, FACS, FAAO · Answer

Thanks so much for posting your excellent question and photos. It’s difficult to determine how thin your skin is from the pics. If it is truly thin, then fillers are not appropriate for you. If there is irregular pigmentation, then erbium laser would be the best solution. If the skin is thin and the blood vessels are showing through, then there is no hood option except cover up. See an experienced oculoplastic surgeon for comprehensive evaluation and proper guidance. Good luck!

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

Leonard Grossman, MD · Answer

In my opinion, the best treatment option for tear troughs and especially in individuals within skin is by means of fat grafting. Using a plastic surgeon with lots of experience in fat grafting techniques performed the procedure, the results should be permanent and natural. I hope this helps and good luck from New York City plastic surgery

Robert T. Buchanan, MD (retired) · Answer

You appear to be an excellent candidate for tear trough filler. When done by an expert it doesn’t matter that your skin is thin because the filler is placed deep on the bone or muscle, well away from the skin. Do not allow anyone to place the filler superficially as this generally causes problems even in people without thin skin.

Tear trough filler or procedure for thin skin under eyes? I am a 35 yr male with pale thin skin. (photos)

Answers (6)

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