What can I do about these grooves underneath my eyes? (photo)

Relax. Fortunately, we have treatments for this very common problem. The routine, daily, at-home use of topical agents, such as topical alphahydroxy acids, such as glycolic or lactic acid products; retinoids, such as adapalene or tretinoin and the regular use of physical sunscreens can be helpful in the long run, for preventing and slowing the development of these wrinkles and crinkles.
In--office treatments, such as the use superficial peels, using high concentrations of glycolic or salicylic acid, and even microdroplets of Botox judiciously placed within the muscle under the eyes, can further improve this issue. Finally, the use of a soft, low viscosity, cohesive, malleable HA filler judiciously injected along the hollows can help to elevate and smooth them and create a smoother transition between the upper cheeks and the under-eyes.
Exercise a good deal of "buyer beware" caution if offered expensive treatments with the expensive, supposedly "next big thing" light and energy-based devices being hawked out there, since the hard science to support these "bells and whistles" lags well behind the heavy marketing hype and social media buzz to promote them. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Hi there,

I know how frustrating it can feel when you start noticing changes around the eyes — especially since this area is so delicate and tends to show signs of aging early. The grooves you’re seeing under your eyes, especially when you smile, are often related to volume loss and the natural changes in skin and fat pads as we get older.

There are a few options that can help:

Dermal fillers: A small amount of filler placed carefully in the tear troughs can soften those grooves and restore a smoother transition under the eyes.

Skin treatments: Light resurfacing treatments, microneedling, or lasers can help with skin texture and elasticity.

Topicals and lifestyle: Good eye creams with ingredients like retinol, peptides, or hyaluronic acid can support the skin over time.

The right choice really depends on how subtle or dramatic a change you’d like, as well as your comfort with procedures. Even small, conservative treatments can make the area look more refreshed without changing your natural expressions.

As an individual ages, they tend to see Fat loss in the face, usually because they’re constantly looking at themselves in the mirror. There’s really only one way to correct that in a proper manner, and that is what the use of fat grafting. In the right hands, fat grafting provides you with natural and permanent results. Fillers in that area tend to have a lot of problems. All of the treatments which involve energy are basically worth worthless. I hope this helps and good luck from Leonard Grossman, M.D., organic Plastic Surgery, New York City.