What procedures would be best for my under eye hollows? (Photo)

Hello! Thank you for your question.As far as I can see from your photos there is extra skin under your eyes. I highly recommend you a lower eyelid blepharoplasty for more fresh, elegant looking.Best Regards!

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Hello and thanks for your question. My first recommendation for your under eye is fat injection. Filler or other options can be used. But I think fat injection gives better result for you.

This is a common question. Eyelid puffiness and hollowness may be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you.

Injectables such as neuromodulators or filler as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

From the photos provided, several simple filler procedures would very likely achieve the desired goals. Since volume deficit in the the upper cheek region, which is a major support for the under-eye region, can be responsible for both the development of the infraorbital tear troughs and the hollows as well as contributing to the development of smile lines, the use of an appropriately robust HA filler for cheeks would likely not only contour a more ideal oval, heart-shaped face, but also improve significantly the under-eyes, as well as diminishing significantly the smile lines. A robust HA filler can also help to define and straighten the jawline and augment the chin, both of which would improve the jawline in profile view. I did precisely this for one of my last patients this past week and it took no more than about twenty minutes. Finally, although it doesn't appear to be needed , at least from the photos, another HA filler can help to straighten the dorsum of the nose. Surgery benefits are not permanent, simply because there will inevitably be volumetric and structural changes that occur with the passage of time that will make further aesthetic work necessary. For the same reason, expensive fat injections cannot promise permanent results. Moreover, much of the fat injected, removed from its native location and deprived of its native blood supply, does not survive. And that which does survive retains the characteristics of the donor region from which it was taken, such as the buttocks, thighs or belly--meaning that when the belly begins to develop midriff bulge, the belly fat in the cheeks may also do so. So, be very cautious when considering surgeries and fat injections. You would be wise to consult with an experienced, board certified cosmetic dermatology injector. Best of luck.

Thanks for this great question and very useful photos. The safest, lowest risk, and most effective single solution will probably be transconjunctival fat repositioning blepharoplasty. Given your skin tone, you’re gonna have to expect some likely transient darkening of the skin called post inflammatory hyperpigmentation. But by going with the transconjunctival approach, this will be minimized. It seems like you probably would get a 60 to 70% improvement in the lower lid cheek junction with that alone. You could add Fat Grafting ( fat is harvested from elsewhere on the body and injected into the face like filler at the same time as surgery) to this and it will probably add another 15 to 20% improvement but you need to go to somebody who does a lot of it because there’s not a lot of room for error and know that it takes about six months start showing effect of the fat grafting. Hope this helps. Good luck.

Hello !

There is 3 variants of the lower blepharoplasty and it can include fat transfer.

An upper blepharoplasty would remove excess skin or ptosis (drooping) on the upper eyelid due to aging or genetics.

Concerning your lower face, I would start light first (and non permanent) with fillers and botox to see if you like the results first. It can reshape your lower face.

Hyaluronic acid would help with your laugh lines. A facelift for nasolabial folds could be a more permanent solution but of course, an « in person » exam is necessary.

I hope this helps, good luck !

Regarding your nose, you need hump resection with osteotomy to make thinner straight nose. Also the tip is little bit drooped so better to do long nose correction. Under eye bag removal can be done on those who look tired and older due to excessive development of fat under the eyes. It occurs as the membrane surrounding the fat under the eyes weaken and lose elasticity. Since the operation is performed under the inner conjunctiva of the eye, there is no occurrence of scaring. Everyone has smile lines, if you want to make it better then I recommend full face fat graft. If you have further questions then please let me know. Thank you!

As you have many areas on your face that you'd like to address it is best to begin by scheduling a consultation with a board certified plastic surgeon near you. You can consider trying filler for under the eyes to help unify contours. I've included a video I hope you find helpful.

Thank you for your question.

Of course and in person examination is necessary to properly diagnose your eyelids.

Based on your photographic procedure called a transconjunctival lower eyelid blepharoplasty with arcus marginalis release and fat grafting can often plump the dark circle and reduce the shadow that you see under your eyes.