Tear trough(bags) from birth. What would be the best option? (photo)

There are 3 options for the congenital tear trough deformity you have with significant hollowness. 1) filler injection; 2) fat injection; 3) tear trough implant.  Each has pros and cons. See an oculoplastic surgeon for evaluation.

Fillers are going to be a better solution than surgery because you need to actually add volume. I would start with a HA filler such as Restylane and see if it delivers the kind of results you want. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

They do require maintenance.  However, the treatment can be modified as your face changes over time, which it does.  Surgeries necessarily create irreversible damage so the benefits need to far out weigh the risks and you are not there yet.  Find a very experience injector in your area.

The lower eyelid skin is the thinnest skin in the body and ages sooner then the rest of our faces. Since you have had these since birth it is more genetic. You could do fillers for the tear trough or a lower blepharoplasty is going to be the most aggressive permanent way of addressing this area for you. I hope this helps.

There is no predictable surgery for this issue. Fillers help to some degree. However they alsol require maintaince. 

You look very young from the photo to have or need any surgery and the photo is not ideal to evaluate things but something more conservative like a filler may be far more appropriate. See a board certified surgeon in your area with an expertise in aesthetic surgery for more information. Good luck!Dean Vistnes, M.D.Vistnes Plastic SurgerySan Francisco Bay Area#realself #drdeanvistnes #eyebags #filler