Am I a poor candidate for under eye fillers? (Photo)

Hi,Based on your photo you have a prominent under-eye fat pad.  You're not the ideal filler candidate but it's still possible to receive a partial improvement with filler by adding volume below the fat pad to disguise the height discrepancy between the bulge and the upper cheek.  You would receive a more complete improvement with blepharoplasty which is a surgery that directly addresses the fat bulge by removing it or shifting it.  

Keep in mind, a combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. 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

Hi,Fillers are not appropriate to treat puffiness, in fact, because restylane absorbs water from nearby tissues, it can create a little extra puffiness. It is hard to tell from the picture you provided if you have a deep tear through (fillers are appropriate here), but I do not think so. Surgery is typically reserved for patients that have a significant fat pocket herniating underneath the eye, I do not see that either. I recommend an in patient examination, sometimes something as trivial as allergies can cause bothersome puffiness. Best of luck,Mehdi Sina, MD

My recommendation would be fractional laser followed by a hydroquinone to lighten the skin.  Your "bulging" is minimal in my opinion but I do think that you could benefit from skin tightening as well as some lightening of the skin.  

You are not the ideal candidate for fillers given the swelling and fat herniation but you would still notice some improvement with filler. I think a better option for you would be to meet with an oculoplastic surgeon to discuss your surgical options. 

Hi ,If you never had eye surgery before or fillers, you can fill the tear trough with juvaderm to soften the depression. This is very technique dependent but works well when done judisciously. A consultation is necessary to discuss whether you are a good candidate and the risks associated with the procedure.Best,Dr.S.