What are the best options to tighten under eye skin with negative vector? (Photo)

Your vector is only mildly negative so you should be fine. I feel the best procedure is to reduce the fat herniation with a transconjunctival incision and then inject harvested fat into the tear trough. I don't like repositioned fat because it can occasionally be lumpy. To tighten the skin, CO2 laser in a controlled fashion works very well. Be sure to see a facial specialist for consultation.

Hello, kjk85, thank you for your question! In our practice we love skin tightening, and see some great results with various devices for under-eye skin laxity. Morpheus8, SylfirmX and ScarletRF are both fabulous treatments that combine radiofrequency with microneedling to tighten the skin as well as improve skin tone and texture. As we age, many factors can contribute to worsening under-eyes, and we address many of them by using RF-microneedling for the entire face. Additionally, the Agnes RF device is used for precision in smaller areas such as under the eyes. It can address fat pads as well as skin laxity. All of this is to say that you can absolutely make improvements without surgery, if that is your preference. We wish you the best of luck in your search! Best, Genie Alexander RN BSN for Dr. Anna Petropoulos MD FRCS at Center for Classic Beauty, Boston & Danvers, MA.

Based on your in person examination, you may also benefit from lateral canthoplasty to strengthen the lateral canthal tendon. I do not recommend transcutaneous lower eyelid surgery or a skin pinch. If you do eventually need skin tightening (remains to be seen) this can be done with a chemical peel.