What can be done about my eyes? (Photo)

Question

Severely black under eyes. Several doctors say skin is too thin and tear troughs too sunken for filler. All say not enough fat for under eye bleph. I look sick but I’m not. Also very puffy upper lids that are sagging now and hanging over lid. Straight brows. I look haggard and want refreshed. Under eyes have NO bags, no fat, just wrinkly loose skin that rolls up when I smile. Upper lids look old and angry

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Zoran Potparic, MD · Answer

It appears that ypu have smalle rcheek bones, condition known as mallar hypoplasia. Due to lack of bone volume, muscle and ligament (which are attached to the malar bone bellow orbital rim), create a groove (tear trough) and give sunken appearance to the eye. Condition can be treated with relaese of muscle and ligament from bone using lower blepharoplasty technique and placement of small implant in the area of bone deficiency. Fat grafting or bone chips placement can also be considered for malar augmentation. In person consultation with board certified plastic surgeon with expertise in oculoplastic procedures and facial implants, is recommended. Good luck.

Kenneth D. Steinsapir, MD · Answer

My father, an internist from Brooklyn, was fond of saying, when the butcher tells you the meat is bad, you should listen. When a surgeon says that something can't be done, they generally mean that they can't do it themselves. There is no substitute for an in person assessment. Having said that, I have many patients who travel from Sacramento to get filler service with me. Under eye filler is a fussy service and your injector really needs to know what they are doing. Your eyes can be your best feature.

Ulas Bali, MD · Answer

With the help of provided pictures, You can achieve younger and fresh look with Blepharoplasty. Removal of extra and sagged skin with almost invisible incision will provide your desired look.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question

There certainly is a way to improve your lower eyelids and lessen the dark circles under your eyes.

There is a procedure called a transconjunctival lower eyelid blepharoplasty with arcus marginalis release and fat grafting.  This procedure is an effective way to lessen the deep dark circles underneath your lower eyelids and the fat grafting can lessen the dark appearance of your lower eyelids.

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