What are my options to treat these mostly genetic dark circles/bags? (photo)

Thank you for sharing your concerns. Based on the information you’ve provided, I believe there are effective solutions to address the bags under your eyes and the dark, droopy circles that make you look older than you feel.
While fillers can provide temporary improvement, especially in this delicate area, they are not always the most practical or long-term solution. Continuous use of fillers can sometimes lead to issues like migration or even exacerbate the appearance of the bags, as you mentioned.
An alternative and more natural option to consider is fat transfer to the under-eye area. This procedure involves using your own fat to restore volume and provide better support to the area, helping to reduce the prominence of the fat pads and smooth out the transition from the lower eyelid to the cheek. Additionally, fat grafting stimulates the growth of new blood vessels in the treated area, improving oxygenation, vascularity, and overall skin quality. Over time, this can enhance the skin’s texture and color, making it look healthier and more youthful.
Another option to explore, especially given the genetic tendency for under-eye bags, is a transconjunctival blepharoplasty. This technique repositions or removes the protruding fat pads without external incisions, addressing the root cause of the issue. When combined with fat transfer, it can create a balanced and rejuvenated appearance.
As for the Halo Laser you’re planning, it can be an excellent treatment for lines and acne scarring, improving the overall texture of your skin. However, it won’t effectively address the deeper structural concerns related to under-eye bags or pigmentation.
I would recommend a personalized consultation to evaluate your specific anatomy and goals. Combining treatments like fat transfer, blepharoplasty, and laser can yield transformative results tailored to your needs.

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for a lower bleph procedure as that procedure will remove excess skin and fullness to your lower eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!

- Lower eyelid blepharoplasty with repositioning (transconjunctival approach- through the inside of the lower eyelid)
- fat transfer and nanofat injections
- skin pinch and/or CO2 laser
- dissolve filler prior to surgery

Important to see an expert for an evaluation. Contact me for more details! Hope this helps!

The Photograph demonstrates herniated fat pads in your lower lids. In our practice, we remove those fat bags through an incision on the inside of the eyelid known as a trans-conjunctival approach. No external incisions are required unless there's significant laxity of your lower lid skin. That will depend upon your age. This procedure is performed under a brief general anesthesia as an outpatient procedure which takes about 30 minutes. Anticipate about 10 days of some degree of visible bruising and swelling after the procedure.