33, under eye dips or wrinkles and malar creases - What can be done for these? (Photos)

Question

Hello. I am currently 33 years old, going to be 34 in july. I have these very, very, very deep under eye dips or wrinkles that I have been self-conscious about since I was in middle school, which is when they appeared. I feel like I have always looked older because of these, and in addition, I have a very deep malar creases as well. I have had one syringe of filler into the mailer crease and saw no results. I figure I'm going to have to do another round of it or maybe even some sort of fat transfer to the creases. But my main issue is really the deep wrinkles. At this point I will even do surgery because I'm tired of looking like I'm tired all the time. What can be done for this? I will take anything at all at this point, whether it's filler or surgery. What about the mailer creases? Please help.

Guray Yesiladali, MD, FEBOPRAS · Answer

The photos should show the full midface in a neutral expression for accurate evaluation. At your age, when these grooves have been present since adolescence, the cause is usually structural rather than purely age-related.
The key question here is your goal:Are you looking for a long-term, structural solution, or are you comfortable maintaining the area with periodic filler and postponing surgery?
If the priority is a non-surgical, maintenance-based approach:• Strategic tear trough and midface filler can soften the grooves• Cheek support may reduce the depth of the malar creaseThis approach requires ongoing treatments and careful technique. Overfilling the crease itself is usually not effective.
If the goal is a more permanent correction:• Lower blepharoplasty with fat repositioning addresses the structural hollow rather than masking it
Fat transfer may be considered in certain anatomies, but durability and predictability vary.
The decision depends on whether you prefer staged, repeat treatments or a structural intervention with a recovery period but longer stability.
Looking tired at a young age can be frustrating, but with a plan aligned to your long-term expectations, meaningful improvement is achievable.
&mdash; Güray Yeşiladalı, MD

33, under eye dips or wrinkles and malar creases - What can be done for these? (Photos)

Answers (1)

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