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

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.

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.

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!