I'm 22, male, with under eye bags, marionette lines and nasolabial folds. What are my options? (Photo)

Looking for help as to what my options are as to getting rid of the nasolabial folds, lines beside my lips going down and eye bags I have. I do not do much excercise at all, eat relatively healthy and drink roughly around 8 glasses of water daily. I feel as though I am too young for my face to be aging this quickly. What are my options and which are the safest and most effective??? seeking for all permanent and temporary solutions, varying from fat grafting, plastic surgery, fillers, ultherapy,

Doctor Answers 7

22 year-old man with tear troughs, deep NLFs and marionette lines

Hey, you probably don't want to feminize your features, right? So a little filler such as #Restylane or #Beletero in the tear trough will probably go a long way to making you feel better about your appearance.

Then since it looks as though your face is fairly oval you could masculinize your features subtly if desired by having some #Voluma or #Radiesse to the jawline, which will help the marioneete lines indirectly, and maybe some Radiesse in the chin area which looks depressed to me, and the marionette lines.

Please leave the NLFs alone; filling them will give you an unnatural, simian look!

New York Dermatologist
5.0 out of 5 stars 8 reviews

22 with bags under the eyes and deep flods...what to do?

Would recommend you first try a HA filler, I like restalyne in the tear trough area and juvederm in the NLF and marionette areas, a guick fix and although temporary would give you the improvment you are looking for.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 85 reviews

Under Eye Bags, Marionette Lines, and Deep Nasolabial Grooves

It is difficult for me to tell if you true bags or just deep grooves at your lid margins. If there is excess fat present, which would cause the bags, the fat can be removed and some used to fill the grooves. Without bags I would fill the grooves with fat taken from another part of your body or Restylane filler. The nasolabial grooves can be augmented with your fat or a filler.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Under eye hollowing

For a 22 year old male (or female) hyaluronic acid gel into the upper cheek and eyelid - cheek junction will be a suitable option for the tear trough hollows and nasolabial and marionette lines because the overlying soft tissue and skin is firm so it will look natural and not show any silvery blue colour effect.
Hyaluronic acid gel filler is less invasive and safer than eyelid or cheek surgery. Restylane and Restylane Perlane, both with lignocaine, can be given via a single entry point on each side, using a canula. The canula helps deliver the hyaluronic acid gel feel in the cheek with a lower risk of entering a blood vessel and so helps lift the trans-cheek depressions and helps camouflage the lower eyelid tear troughs. The nasolabial folds can either be injected using several needle pint injections, or predominantly by canula. Very gentle light Restylane around the mouth and chin will help the marionette lines. 
Check the potential side effects before proceeding. Any injection of filler can cause bruising, swelling, very rare risk of entry into a blood vessel with serious effect on vision or neurological effects. Hyaluronic acid gel is reversible with an off licence use of hyaluronidase in the UK if the volume is wrong or it looks asymmetrical. Very rare biofilm complications can also occur. 

Jane Olver, MBBS, FRCS
London Oculoplastic Surgeon
4.3 out of 5 stars 6 reviews

Under eye hollowing and marrionette area

At this age, you don't have much laxity in the tissues.  You could nonetheless, do a lower lid blepharoplasty and a lower face lift to soften the shadows... but these are invasive procedures and you may be looking for some less invasive options.  For the non-invasive, I would consider dermal fillers.  Ultherapy would also help tighten some of the areas of concern.  The in between option of doing something like fat grafting is also an option, but you may need two rounds depending on how much correction you get with round one.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Filler or Blepharoplasty ?

In regards to your specific under eyes, the likely best treatment would be filler injection into the hollow area below the "eyelid bags" although sometimes it is best to perform lower blepharoplasty with fat repositioning (where the eyelid bags/fat are moved into lower position to fill the hollow area).  It is best to seek in person consultation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Help with nasolabial folds, down-turned mouth, and undereye bags

I would recommend starting with a hyaluronic acid filler like Juvederm or Voluma which will last a good 1.5-2 years and is reversible if you don't like it. The filler should be placed in your upper cheeks, and a little in your lateral chin to assist in improving the folds laterally.  With an experienced injector, you should be able to get a nice, natural improvement of your nasolabial folds, down-turned mouth corners, and undereye grooves/bags.  If you do have undereye bags from fat, then you may be a good candidate for lower lid blepharoplasty.  

Karen Stolman, MD
Sandy Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.