Hollow under eyes with discoloration | prominent bone showing on profile view (Photo)

Question

What would my best course of action be for this? In my early 30's and these dark colored bags under my eyes seem to be getting worse - constantly look tired and/or sick. Any steps in the right direction (regarding what to research) would be appreciated. Thanks!

Raffy Karamanoukian, MD, FACS · Answer

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 
Recommended Creams: Melarase Brightening Kit
MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Under eye hollows can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. Lasers can be used in combination to give improvement. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Rian A. Maercks, MD · Answer

Great question!  You are very astute to recognize hollowness!  There is often a knee jerk response to offer a surgical blepharoplasty in cases like yours, however this is a mistake because 90% of the cause is volumetric.  performing a blepharoplasty without treating the volume will result in very surgical results that do not enhance aesthetics.  I commonly correct these issues with a treatment that I call "Aesthetic Facial Balancing" using a special application of hyaluronic acid fillers.  Using this technique the eyes become brighter, the face appears more healthy and youthful and a natural appearance is maintained. The best part is it is a twenty minute procedure with no surgery and quick recovery!  Another option is to complete this correction with your body's own fat.  Review before and after pictures of various techniques and you will understand the importance of volume over surgery in your case.  I hope this helps!All the best,Rian A. Maercks M.D.

Richard Galitz, MD, FACS (in memoriam) · Answer

This is a somewhat difficult problem because of your natural facial idiosyncracies. I think there is only one practical solution and that is the judicious placement of filler to soften the hollow and drop off created by the prominent malar bone. Suctioning out your own fat and placing it in this area is also a viable choice but a more difficult one for you. I would take the filler route first, see how you like the results and then consider fat at a later date. Most important here is to find a surgeon with the skill and artistic expertise to place the right amount of filler in just the right place ...sounds easy but its not.

Hollow under eyes with discoloration | prominent bone showing on profile view (Photo)

Answers (5)

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