What will help my genetic purple under-eyes? (photos)

Question

Dear doctors, I always suffered from purple eye bags since childhood. Some doctors offered mesotherapy bu they stated it would be of limited help. I gave been researching options like laser, fat graft etc. Or even rim implants but I would like to hear your expert opinions on what will do good for me?

Nelson Lee Novick, MD · Answer

At least from the photos provided, your problem is certainly not unique. Since the upper cheek is a major support for the under-eyes, the use of a robust HA volumizing filler concentrating on the upper cheek-lower border will likely significantly improve the appearance of the bags and diminishing the shadowing of the area due to the hollowing. My last patient of the day yesterday, a 34 year-old woman, had this exact issue. Occasionally, additional filler placed in the infraorbital area may be added, if needed, for additional improvement. These are advanced injection techniques that should not be left to the hands of novice, inexperienced injectors trained largely to treat ordinary smile lines with plain Juvederm or simple Restylane. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Mats Hagstrom, MD (license on probation) · Answer

Before recommending a procedure, we need to have a clear understanding of what the underlying problem or ideology is.
In your case it can be separated into facial contour and skin color.
Issues related directly to skin complexion and skin color are probably a little more potentially challenging to treat.
Contour and how the light throws shadows Can impact darkness and perceived color in the lower eyelid region.
When we look at ideal facial aesthetics and the appearance of the youthful face, there are two variables that remain consistent.
The first is that the contour along the lower eyelid is generally snug and tight.
The second is immediate Fullness as the eyelid transitions to the midface.
With facial aging, we see each of these variables create opposite contour issues.
In the aged face we see bulging in the lower eyelids as the period orbital septum becomes weak, allowing for protrusion of the three fat pads deep to the lower eyelid. in the area just below the lower eyelid, we see a loss of volume in the beginning of the midface.
These represent two adjacent problems that both contribute to signs of facial aging.
Sometimes bulging of the lower eyelids is the primary problem, and sometimes loss of midface volume is primary.
Sometimes they are of equal importance.
 These contour issues can have an enormous impact on the perception, including discoloration because of how the light reflects and shadow formation.
To answer your question treatments can be based on the skin, color itself, bulging of the lower eyelids or loss of volume in the upper mid face.
 Depending on which one of these is the primary cause of discontent should help direct the best course of action.
Quality plastic surgery process always begins with having a clear understanding of what the underlying ideology or problem is.
Once we have a clear understanding of the problem, we can then begin to start considering treatment options.
To get a better assessment, and insight into various treatment options I suggest, scheduling multiple in person, consultations with plastic surgeons, facial plastic surgeons, or oculoplastic surgeons in your community.
You may find that different providers offer different opinions in regards to both assessment and treatment options.
This is often the case when there is complexity, and multiple variables.Best, Matt Hagstrom, MD

What will help my genetic purple under-eyes? (photos)

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What will help my genetic purple under-eyes? (photos)

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