What can be done for sunken hollow dark tear troughs with thin loose wrinkly skin? (Photo)

Hi,

Thank you for your question and for sharing your photos.

In my clinical practice, when filler injections are not recommended for the tear trough area due to thin skin, alternative treatments can be considered. After performing a detailed physical examination, I always provide patients with several options. One option is to improve the quality and texture of the skin around the tear trough area. This can be achieved through non-surgical treatments such as laser resurfacing, chemical peels, microneedling, and radiofrequency procedures like Morpheus 8 and Exilis 360 Ultra. These procedures aim to stimulate collagen production, improve skin elasticity, tighten the skin, reduce wrinkles, and enhance overall texture.

Additionally, the use of skincare products containing ingredients like retinol and Vitamin C can stimulate collagen production, improve skin darkness, and promote a brighter complexion.

In cases where the cheeks appear sunken and the tear troughs are prominent, cheek augmentation might be an option to consider. This procedure involves adding volume to the cheeks using dermal fillers or fat grafting. By restoring volume to the midface, the prominence of the tear troughs can be reduced.

It is crucial to consult with a qualified and experienced doctor who specializes in facial rejuvenation. They will be able to evaluate your unique situation, discuss your concerns, and recommend the most appropriate treatment options for you.
Hope this helps,
Best wishes,
Dr Giuseppe Fiore

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.