How to fix my under eyes? Young, in 20s. Is it orbital fat loss? Did my cheek pad fall? Please help. (Photo)

You may want to talk to a doctor to see if fillers may work for you. Maybe talk to them about Belotero, or what other fillers they recommend. this is something that you do not need surgery for unless it is necessary

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.  All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Thank you for the question and photos. You probably should do nothing. Your eyelids look nice and normal. From the photos it seems that the globe (eyeball) protrudes slightly into eyelid, creating a shadow beneath it. There is no need to treat this and probably would not look better with fillers. See an experienced Oculoplastic Surgeon in person for full evaluation and discussion of possible treatments (if any). Good luck.

You could have cosmetic help at the top of the cheek with Restylane filler.  You need to find an expert injector for this.  Please do not get treatment with Belotero or Juvederm.  Do not let anyone treat you Radiesse for this area.  Less is more.  Before you try this, consider eye concealer which helps to make the dark circle better.

At your age addressing the pain should be important, but the short answer is filler for the hollow.  With your young think skin just about any filler will work, but I would avoid Juvederm in that area.  It tends to absorb more water and looks puffy.  Done well any other filler will work great.  I would also consider fat grafting to the area. You have many years of filler ahead and fat would be the most cost effective.  I would search for a board certified plastic surgeon to do this and one that has experience in that area.  It is a great filler in the right hands.  If you find someone who says it does not work well there, then run.  It means they do not know how to use it in the area.Good Luck!

Thank you for your question.I am unable to explain the pain your are getting at your lid/cheek junction. For this reason alone I think you should seek an in-person consultation with your local doctor. In terms of the cosmetic appearance of your eyes, your photos didn't appear (to me) to show anything that I would be rushing to do anything about.In a nutshell, get the pain checked out but otherwise your lower eyelids look fine.