What would you recommend for my tear trough deformity? (photos)

Hi Alyssa.  We have had several young patients like you who have tear troughs related to genetics rather than age.  In these situations, Restylane is an excellent option for helping improve the appearance below the eyes.  To see other before and after pictures of Los Angeles tear trough injection patients, including one that very much resembles your situation, click on the link below.

You appear to have more hollowness (in the area of dark circles) that fullness/puffiness (above the area of the dark circles), which means you would probably benefit from filler injection in the hollow area to the contour more even.

Based on only one picture you sent, it appears you do have a tear trough but I cannot tell it's severity.  A good exam by a board-certified plastic surgeon would help.  I personally would be uncomfortable treating a 16 year old for this problem.

The small fullness in your orbital rims is not "herniated" fat but your orbital rim.  A bit of softness in the lower eyelid is normal.  It tells people that you have a lower eyelid.  If this area is filled in with fillers, you get the "mono cheek."  This looks goofy.  The can be occupational reasons even at your age for doing filler service for the lower eyelid.  If you are modeling or acting, there can be pressure to look as good as possible.  Under that circumstances, services are sometimes provided for very young people with the permission of their parents.

Tear trough deformity in young. I need to see photos to be able to tell u what would be best--an exam is better. 

Dear Alyssa92,If you were in your twenties or beyond I would likely recommend fat grafting or one of the off the self filler such as Restylane/Juviderm.  I don't know what age is too soon and I guess it depends on what the treatment entails. Regardless, I think it would be wise for you to sit down with your parents and a knowledgeable aesthetician and at first evaluate what non-surgical options are available for you.  Surgery such as fat grafting is always available down the road.All the best,Dr. Remus Repta

The changes you're showing in the photo are fortunately pretty subtle.  You have tear troughs in the normal range which are just a little on the deeper side.  The skin being darker is also normal for this area.  At this age, I would continue conservatively and use make up for the covering.  Some patients try something non invasive first like bleaching creams (hydroquinone 4% - prescription needed), or laser.  Using fillers might help the depth of the tear trough, but they can also highlight the darkness more as the trough is pushed out. Recently some very thin sheeting has been released on the market to resolve under eye issues, but these are more beneficial for excess and wrinkly skin. All in all, I would be very conservative at this time.  And this is advice from a fairly aggressive surgeon. 

You are still growing and your face is changing. You may end with a persistent tear trough hollowness which would benefit with expert filler infection, but I would recommend waiting for another couple years.