Best solution for asymmetrical under-eye area in early 20s? (Photo)

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

You have under eye bags (fat prolapse) and tear trough hollowness (dark circles), asymmetrically. Options are filler injection in hollow area vs. lower blepharoplasty (transconjunctival) with fat repositioning. Each has pros/cons. See an oculoplastic specialist.

What you are feeling is your bony orbital rim and not herniated orbital fat. For you under eye fillers are a better option than surgery.  I have one of the largest practices of filling under eye circles and see pateints for this from all over the world.  You are asking for the doctor to sculpt your face.  To not let anyone inject you in this area with the smooth fillers like foul Volbella, Restylane Silk, and Belotero for example.  These products do not stay precisely where they have been put.  They are called smooth because they drift after injection to smooth bumps.  That does not work for the under eye area.  You need a precisely placed filler that does not drift to get the best possible result.  I use Restylane for this purpose.  Service last a year or more.

Fillers, lasers, and microneedling/PRP can improve under eye bags and circles. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

Thank you for your question.  Based on the photos provided, there is bulging of the lower eyelid fat pads.  This is more common in older individuals by can also present earlier.  Definitive treatment in the surgical removal of repositioning of the fat (i.e. lower eyelid blepharoplasty).  In certain cases, the bags can be camouflaged with conservative dermal filler treatment.  See a specialist to learn more and best wishes.  

The hollowness comes from lack of soft tissue under your eyes.  This can occur when you are in your 20's.  The puffiness is usually a fat pad and this can be removed surgically.  When a patient comes in for this problem and they are in their 20's, the usual treatment is filler.  Surgery is rarely the answer when someone is so young.  The best way to know for sure is a physical exam and evaluation.  Good luck.

Fillers can be used to add volume to hollow areas.  Under the eye is a delicate area so be sure to visit with an experienced injector.  There are several different fillers available, consulting with an expert will help determine which is best for you.

It appears from your photographs that you have slightly greater orbital (eye socket) fat cushions on the left than the right. The left fat pockets can be contoured back through a procedure called 'transconjunctival blepharoplasty,' or going through the inner lining of the lower lid to contour the fat cushion. But having said that, your asymmetry appears to be somewhat subtle. It's possible that your lids would still not be perfectly symmetric. When I see a patient with this degree of asymmetry, I encourage them to wait till it grows more significant.