Deep lines under eyes - Is it genetics? How can I treat this? (Photos)

Question

hello! ive developed deep lines under my eyes and dont qu understand what is it exactly hence do not know how to treat that condition:( any info wpuld help! ive had fillers under eye tear drop are more tgan 5yeara ago could it be a migration?

Jeffrey H. Spiegel, MD · Answer

Undereye lines and concavities are typically caused by loss of volume as appears to be in your case. My recommendation is undereye hyaluronic filler, AKA Tear trough filler with a drop (and I mean a drop) of toxin, like 1unit of Xeomin for the undereye "jelly roll".  The good news is that this is easily fixable and will last for years.

Nelson Lee Novick, MD · Answer

From the photos provided, it would appear that the use of an appropriate robust HA volumizing filler for cheek augmentation properly injected would accomplish not only creating a smoother, gradual upper cheek-lower lid transition, but would at the same time enhance a more heart-shaped oval shape to the face. As an added benefit, very likely, the incipient smile fold noted on the left side would also be improved as a result from the lift achieved with this treatment. 
In the hands of an experienced, board certified cosmetic dermatologist filler expert injector, this treatment should take no more than ten minutes to perform and typically produces immediate results and engenders little to no signficant downtime I hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and photo. I can understand why this is bothering you—it’s very common to notice changes under the eyes over time, and it can feel frustrating trying to figure out the cause and treatment.

From what you describe and the photo:

Genetics and natural aging: Deep lines under the eyes are often a combination of genetic predisposition and natural aging. The skin under the eyes is very thin, and with age, we naturally lose fat and collagen in this area. This can create pronounced lines or hollows, even if you’ve had treatments before.

Previous fillers: Since you had tear trough fillers over 5 years ago, it’s unlikely to be migration of the filler, as most hyaluronic acid fillers naturally dissolve over time (typically within 1–2 years). Any visible lines now are probably due to natural volume loss and skin thinning rather than leftover filler.

Other contributing factors: Sun exposure, repeated facial expressions, and lifestyle factors (sleep, hydration, smoking) can also make these lines more noticeable.

Treatment options: Depending on the exact cause, there are several ways to improve the area:

Dermal fillers: Carefully placed under-eye fillers can restore lost volume and soften lines.

Skin treatments: Laser resurfacing, microneedling, or chemical peels can improve skin texture and stimulate collagen.

Topical care: Retinol or peptide-based creams can help maintain skin thickness and elasticity over time.

It’s understandable to feel unsure about what’s happening under your eyes, but in many cases, these lines are a normal part of aging and can be softened with targeted treatments.

Deep lines under eyes - Is it genetics? How can I treat this? (Photos)

Answers (3)

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