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The skin folds that concern you are often referred to as malar mounds. They can be difficult to treat. Some patients find improvement with Morpheus8. This treatment combines RF technology with microneedling to improve overall skin tone and texture. You can also consider replenishing volume of adjunct areas to give a refreshed look with traditional HA fillers or Sculptra.
From the photos there appears to be volume deficit in the cheeks, not only as evidenced by the depression below the bags, but by the prominence of the smile lines. Since the upper cheek region is a major support for the under-eyes, any loss of volume there would give rise to sagging under the eyes, and the loss of the cheek lift gives rise to more pronounced smile lines. The use of an appropriately robust Ha volumizing filler skillfully injected by an expert would be a simple remedy that would address both issues in one fell swoop. In expert hands, treatment would take about ten minutes to perform, with typically immediate results and little to no signficant post-treatment downtime. This problem is so common in my experience, that this particular treatment is practically a daily staple in my practice. You would be wise to seek consultation and treatment by an experienced, board certified cosmetic dermatologist filler injector expert. Hope this helps and best of luck.
Hello P,Many patients like you are presenting to our practice. I recommend first replacing your lost facial volume with biotimulatory rejuvenation using either Sculptra or hyperdilute Radiesse/prp. Micro-focused ultrasound of your malar swelling is performed at the same time. The lost volume immediately under your eyes can further restored with EZ-Gel. The most important aspect of your treatment is choosing your expert treating physician. Good luck and be well.Michael A. Persky, MDEncino, CA
Thank you for your inquiry! By your photos, it looks like you would be a great candidate for a lower bleph procedure as that procedure will remove fullness and excess skin to your lower eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!
The treatment of the MALAR bags is difficult. I have had some success with the Endo laser under local anesthesia fee $2000. May need more than one session best to virtual consult with.