Hello, and thank you for your question. You have several options to treat the under-eye area. Dermal filler injections into the tear trough, usually via a microcannula, adds subtle volume to reduce fine lines and discoloration. Facial fat transfer uses fat from other areas of your body to treat the sunken area under the eye to create a more youthful facial appearance. This can be done in conjunction with lower blepharoplasty (eyelid surgery), which surgically removes excess skin and repositions fat to create a smoother transition from the lower eyelid to the cheek. Lasers, Profound RF (microneedling combined with RF energy), and other procedures that help boost collagen production can be very effective in tightening and refreshing the skin around the eyes too. A combination of procedures can provide you with optimal results. To determine the best treatment/s for you, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, customize the best treatment plan, and ensure the best possible results.

Hi @lovelygirl001! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area.

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments. 1) Skincare with products and microneedling/PRP 2) PDT Light Therapy a few times per month with growth factors 3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year 4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill 5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting 6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest Best, Dr. Emer."

Thank you for your question. This is a super common concern. Usually adding volume under the lower eyelid helps give a refreshed appearance. There are a few ways to do this. Filler is often a great place to start, as it treats the region well and if you don't like it, it isn't permanent. Fat transfer involves taking fat, often from the stomach region, and adding some to the cheeks. Think of this as more of a permanent type filler. Lastly, there is a procedure called blepharoplasty, in which lower lid fat pads are reduced in size or moved, and sometimes a little skin excess is removed as well. There are pros and cons to each of these, as well as differences in downtime to consider. I hope this is helpful, and all the best. -Dr. P

Hi, Thank you for your question. I have reviewed your pictures and it is important to mention, that one of the elements that create the appearance of eye bags is the loss of volume under your eyes. For this reason, I believe there are two solutions how to address your concern: either proceeding with non-surgical treatment, which would be a tear-through filler injection or a more permanent solution, which would be a Fat Injection in the zygomatic area.