How to fix lines/creases under eyes?

I have these creases under my eyes, and they make me look tired/stressed, and older than I am. What can I do to fix them? Any permanent options?

Doctor Answers 5

Tear trough

Thank you for posting your photos. Looks like you are starting to develop a tear trough deformity. This can be easily corrected with fillers. A less hydrophilic filler such as Belotero is good for this area. Your eyes will look less hollow and more rested. Sometimes by filling a depression on the lower eyelid, the dark shadow associated with it improves as well. Hope this was helpful. Good luck!

Lower eyelid creases

Lower lid creases are most commonly corrected by chemical peels or CO2 LASER treatments.  Fillers such as fat and PRP injections are other less reliable or permanent options.  Treatment with Retinoic Acid is good for long term maintenance.
Please use this information when consulting in person with an experienced Board Certified Plastic Surgeon.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Under Eyes

Hi theguy1999

Thanks for posting. You seem very young so you may want to start with non surgical options. Obviously diet and exercise will be beneficial for you.

PRP: Platelet Rich Plasma involves the injection of a patient’s own plasma and growth factors in to targeted areas by a cosmetic specialist. The small injections of PRP can significantly improve the appearance of skin by regenerating collagen production, which can assist in adding volume, improving fine lines, scar improvement. PRP can also address the dark areas under the eyes.
Filler: Wrinkles, creases and lines in these areas can be treated by filling the skin with a specially formulated gel ‘filler’. This is injected into or under the dermis (the deepest layer of the skin), pushing up and flattening the crease or wrinkle. There is a very wide range of products currently available and the most usual component in modern wrinkle fillers is hyaluronic acid. This substance is found naturally in almost all body tissues. When injected as a filler, it is immediately effective in correcting creases and is slowly absorbed over 6-12 months. 

Lower eyelid surgery aims to address the bags under the eyes. Excess skin and removal or reshaping of the fat smooth’s the contour between the lower eyelid and the cheeks. Your cosmetic surgeon will assess if the procedure can be performed under local anaesthetic.

Fillers

I think you would do well with a little HA filler such as Restylane to fill in the hallow under your eye and reduce your dark circles. Schedule a consultation with a board certified plastic surgeon to discuss. Although the results aren't permanent, they do last anywhere from 6-9 months and beyond with regular touch ups. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 52 reviews

Fillers

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.