Long-term treatment for under-eye hollows? (photo)

Most expert experienced artistic plastic surgeons have a
variety of procedures at their disposal to produce excellent cosmetic results
in the appropriately selected patient: temporary fillers with hyaluronic acid
fillers like Restylane which usually last 6 months to 1 year, micro-fat grafts
of your own tissue - 30-50% lasts permanently, and blepharoplasties which are
more than you would need at this age. There is no one best procedure that would be applicable for everyone. Each has
benefits and potential drawbacks. The vast majority of board certified plastic
surgeons with extensive experience in eyelid surgery and soft tissue fillers
would warn against using a permanent synthetic filler because of the long term
complications which can occur even years after injection and are difficult if
not almost impossible to correct.The best option in any particular patient needs to be
individualized based on desired outcome and anatomy.Following the advice of anyone who would presume to tell you
exactly what to do based on limited 2 dimensional photos and without taking a full
medical history, examining you, feeling and assessing your tissue tone,
discussing your desired outcome and fully informing you about the pros and cons
of each option would not be in your best interest. Find a plastic surgeon that
you are comfortable with and one that you trust and listen to his or her advice.
The surgeon should be certified by the American Board of Plastic Surgery and
ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).
You should discuss your concerns with that surgeon in person.Robert Singer, MD FACSLa Jolla, California

There are many treatment options. At a young age like yourself I would avoid a surgical procedure for now. Temporary fillers would be the lowest risk procedure for you. See a surgeon who performs all types of lower eyelid surgery and fillers to get an objective assessment.

The actual bone structure responsible for the hallows one sees, is constantly changing. Therefore, a permanent solution is difficult. If the hallows are in part caused by volume loss, I prefer using a hyaluronic acid filler. If it is skin changes accounting for crepiness under the eye, I like to use a fractionated CO2 treatment. Ultimately it is a combination approach, addressing the different signs of facial aging that give a natural and enhanced result.