Non-surgical options for undereyes - Tear trough hollowing, bulging fat pad, excess skin and discoloration? (photo)

Based on your two photos, you appear to be relatively young, and you appear to have bulging fat pads in your lower eyelids. Injecting the lower eyelid groove may be considered, however, I suspect that these congenital fat pads would look best if they were removed, without an external incision. I hope this helps! Sincerely, Dr Joseph

Hello, thank you for your question. From looking at the photos, it appears that you have fat prolapse in your lower eyelids so you would not be a good candidate for tear trough filler. You would need the volume reduced by lower eyelid blepharoplasty - this can be done with a scarless transconjunctival approach (going through the back of the eyelid) and can then consider some light laser resurfacing to the eyelid skin. Please see an experienced oculofacial plastic surgeon for best results.

Based on these photos, extra skin is not a big issue. You have very thin skin so undereye fillers is going to be frustrating. There is no substitute for a detailed in person assessment.

Based on these photos you seem to be excellent candidate for transconjunctival lower blepharoplasty. Through a small incision inside you lower eyelid a surgeon can remove protruding fat pads and release muscle and ligament which create tear trough deformity. In person or teleconference with a board certified plastic or oculoplastic surgeon is recommended. Good luck.

The upper mid-cheek area is an important physical support for the under-eye regions. When there is volume deficit in this very vital area, as seems to be the case from the two photos provided, then the appropriate choice of an HA volumizing filler, properly injected by an expert filler injector, can not only directly revolumize and recontour flattened cheeks, but secondarily diminish the smile folds below at the same time creating a smoother transition between the upper cheek and the under-eyes, thereby addressing hollows, tear troughs and bags. In the hands of a skilled injector, this procedure should take no more than about fifteen minutes to perform and typically yields immediate, on-the-spot results, and engenders little to no significant downtime. You would be wise to consult consult an experienced, board certified cosmetic dermatologist filler expert who can assess your history and suitability for this simple, nonsurgical approach. Best of luck.

You identified eyelid issues. They need to be addressed to correct your concerns . Mid face fillers will help the midface not the eyelids.

You have significant herniation of fat and the two out of the three fat pockets in the lower lids. This is also called a prolapse. Do not have extra skin based on these limited photographs. We do not recommend fillers placed in this area due to significant complications that can happen such as blindness. Also important to get your allergies under control with nasal sprays, antihistamines and decongestants. A trans-conjunctival approach lower blepharoplasty can accomplish removal of these fat pads as an outpatient procedure under general anesthesia, which takes about 30 minutes. The incisions located completely on the inside of the lower lid, and there's no visible external incision. That's going be your best solution.