What can be one to minimize the appearance of smile lines and dark under eye bags? 27 y/o (photos)

Question

I sleep well every night and drink plenty of water a day. I don’t drink or if I do it’s once every couple months, eat well, and go to the gym every day. But I have these eye dark eye bags and smile lines at 27. Idk what to do about it. Healthy as I can be, 15% body fat as well.

Anna Chacon, MD, FAAD · Answer

Thank you so much for sharing your photo and your routine. First, I want to reassure you, you’re doing a wonderful job taking care of yourself, and sometimes these changes show up even when we eat well, stay active, and live a healthy lifestyle. Genetics and natural skin structure can play a big role here, so it’s not something you’ve done wrong.

For the smile lines, at your age, I usually recommend starting conservatively. Options like a light hyaluronic acid filler can soften those early creases, or we can consider treatments that build collagen naturally—such as microneedling, radiofrequency, or laser resurfacing. Even prescription-strength retinoids can gradually help smooth and strengthen the skin.

For the under-eye area, the best approach depends on whether the concern is more from hollowing, pigmentation, or puffiness. Fillers can help if there’s hollowness, while brightening creams, chemical peels, or certain lasers can help if there’s pigmentation. If there’s more puffiness from fat pads, sometimes procedural options work best, but we can often improve the appearance with non-surgical treatments first.

At 27, my advice is to start gently. Think of this as a chance to maintain and enhance what you already have, rather than needing anything drastic. With the right approach, these areas can be improved significantly while still keeping everything looking natural.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Based on your concerns, to minimize the appearance of smile lines (nasolabial folds) and dark under-eye bags, there are several treatments available. I recommend treating smiling lines with dermal filler and treating dark pigmentation with a PICO laser. Hyaluronic acid fillers can be used to fill in and smooth out nasolabial folds, reducing the appearance of smile lines. They can also be used judiciously in the tear trough area to improve the appearance of under-eye hollows.  Laser therapies, such as PICO, can target pigmentation irregularities and stimulate collagen production, improving the overall appearance of the skin around the eyes and on the face. Both are excellent treatments and I highly encourage you to try them! I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

Koodos to you for all the healthy things you. However, genetics plays a big role in the development of issues like this. At least from the photo there appears to be volume deficit in the cheeks, which can easily be corrected with use of a robust HA volumzing filler, and since the upper cheek region is a major support to the under-eyes treating the cheek as above will likely improve the problem under the eyes as well.  The results are typically immediate and there is typically little to no significant downtime following the treatment. 
You would be wise to consult with a board certified cosmetic dermatologist filler expert and best of luck.

Camille Cash, MD · Answer

Carefully placed filler can improve the appearance of smile lines and under eye bags.  We also recommend taking great care of your skin by using medical grade skin care products like Transform MD and wearing sunscreen every day.

Leonard Grossman, MD · Answer

Your diet, exercise and healthy sleep patterns have nothing to do with what the presentation you have because you’ve had it your whole life and even when you’re very little, just not as noticeable.. What you have is a condition which is purely hereditary, and usually gets transferred from the father side of the family. The only and the best way in my opinion to get rid of this is by means of fat grafting into the tear trough as well as the lower eyelid area. In the right hands, it should provide natural and permanent results. I hope this helps and good luck from Leonard Grossman MD organic plastic surgery.

What can be one to minimize the appearance of smile lines and dark under eye bags? 27 y/o (photos)

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