What treatment option is right to treat my under eye area? (Photo)

Question

I am a 28 year old female and would like some suggestions on how best to treat my under eye area. My concerns are mainly the fact that even when making no facial expressions I have a tear trough like line under both eyes. My additional concern is that when I smile I get lines under my eyes and the under eyes seem slightly sunken. I have quite chubby cheeks so I believe this is contributing to it. I previously had tear trough filler but had to get it dissolved after my under eye turned blue

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

Thank you for your question and the photos you provided. I’m sorry that you had an unfortunate experience with filler treatments in the past. When injected by a skilled injector with a blunt-tipped microcannula instead of a needle, this option is effective at treating the under-eye area. 
If you are hesitant to give fillers another try, you may benefit from RF microneedling treatments to increase collagen and elastin production. Radiofrequency energy is delivered to the skin through hair-thin needles to stimulate a healing response, resulting in smoother and firmer skin over the course of several months. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon and injector who can suggest the best approach to help you achieve your aesthetic goals.

Camille Cash, MD · Answer

Based on your photos the easiest way to improve this area is from well placed fillers.  I'm not sure what caused the issues from your prior treatment.  If you are wanting long term results you can consider fat grafting as an alternative.  See a board certified plastic surgeon near you to learn more.

Harold J. Kaplan, MD · Answer

Hello Caring.  With your age and lack of loose skin under the eye you are a good candidate for Restylane injections (see link).  1-2 syringes of Restylane will do the trick and it sounds like you had some poor injection technique previously (Tyndall effect) and that created the bluish effect.

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

What treatment option is right to treat my under eye area? (Photo)

Answers (6)

Answer: Under Eye Treatment Options for Dark Circles

Answer: Under Eye Treatment Options for Dark Circles

Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP

Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP

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What treatment option is right to treat my under eye area? (Photo)

Answers (6)

Answer: Under Eye Treatment Options for Dark Circles

Answer: Under Eye Treatment Options for Dark Circles

Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP

Answer: Improving Under Eye / Tear Trough with Injectable Fillers (Belotero, Volbella, Restylane Silk) -- add Lasers, Microneedling/PRP

Browse related questions

Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.