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

Thank you for your question. We have several treatment options available to address your concerns. One highly effective option is the Neogen Plasma treatment. Neogen utilizes plasma energy to lift, tighten, brighten, and volumize the skin, providing a non-surgical solution. This treatment works by stimulating the production of collagen and elastin, which helps to enhance skin tone, firmness, and texture, resulting in a fuller, smoother, and tighter appearance. The full benefits typically become apparent within 6 months after this single treatment. Many patients are opting for Neogen as either a replacement or a complement to dermal fillers, often achieving comparable or even superior results.

Hello and thank you for your question. Options to address volume deficiency include injectable fillers, autologous fat grafting and malar implants. Sometimes, these procedures are combined with surgical approaches to address other areas of aging face concerns. You may consider a detailed consultation by an experienced facial plastic surgeon who can address your specific needs and provide the best recommendation to achieve your desired result.

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.

The upper cheek region is a major support for the under-eye area. When there is volume deficit there, as appears to be the case here as evidenced by the flattening and lack of projection of the upper outer cheek regions, the infraorbital area can appear sunken, dark and with bags. An appropriate choice of HA filler injected properly in the upper outer cheek region can not only contour a more desirable heart-shaped oval face shape, but can supply sufficient support to the under-eyes to reduce the hollows, tear troughs and even lighten the dark circles . You would be wise to consult with an experienced, board certified cosmetic dermatology injector. and make sure to ask to see his/her personal befores and afters prior to agreeing to proceed. Hope this helps and best of luck.

Hi there

Cheek filler may soften the contrast between your hallow under eyes and cheeks.
Rejuran is a polynucleotide injectable treatment that is great for the delicate under eye area. It can help reduce fine lines and dark circles. As always, please ensure you consult with an experienced cosmetic professional.

Thanks for your question. A great combination procedure for you to consider would be micro-focused ultrasound for skin tightening and smoothing- specifically Sofwave- expect to do 2 or 3 sessions a month or more apart. After that you could do a maintenance session every 1-2 years. We give our clients the option to do Sofwave under eye only at a fairly low cost. Of course, it is commonly also done for larger regions such as full upper face, full face, or full face and neck.
Combine that with a high dose PRP (platelet rich plasma) tear trough injection to boost volume and lighten the skin. That too could be done as a yearly maintenance. I hope that helps!

Hi and thank you for your question. The area under they eye is one of the most challenging for injectors. If you find a good injector with experience in that area, you can get a significant improvement. HA dermal fillers, PRF, and PRGF are some options. The latter two can give you a very natural and long lasting result. Ask the injector to show you before and after photos of the undereye that he/she has performed. In our clinic, we use all three and sometimes use AgnesRF to reduce the size of the under eye bag as well. Good luck!

Everybody has thin skin undereyes . This area is very delicate but with proper technique and product you can absolutely get dermal filler treatment done there.

Thank you for your question and there are a few options for you! I would highly recommend starting with PRP or PRF. It uses your bodies own platelets to produce collagen and help with the crepiness, fine lines, and even helps with the dark color. Another option would be a CO2 laser treatment around the eyes. This will need to be done in the fall as it is a sun sensitive procedure. This will also help to tighten the skin around the eyes helping it look less thin. One more option would be smooth threads which can be placed around the eye area to help build collagen. Anything to build collagen in that area will help with the skin. Good luck in your journey!