What is this sunken skin under my eyes? It looks deeper than skin on rest of my face (Photos)

Question

It just looks like the skin under my eye is deeper than the rest of the skin on my face. I put vaseline under my eyes and it looks like it just gets worse

Dana Goldberg, MD · Answer

What you are seeing is a place where the skin is firmly attached to the bone underneath the eye socket. It can create a shadow that we referred to as the tear trough. Although lower eyelid surgery can address this, at your age, it is probably worthwhile considering injectables or fat transfer to this area. These are less invasive procedures.

You need to go to someone with an extensive amount of experience injecting in this area or it can actually create more swelling. I recommend someone who does both surgery and injectables so you know they are giving you their opinion about the best option (not just the option they do).

Nelson Lee Novick, MD · Answer

At least from the photos provided, there is nothing particularly unusual about the under-eye depressions in the skin seen. These commonly develop in the course of the passage of time and and the onset, rate and extent of their development has a strong family trait component, which can be further impacted by environmental factors. Happily, nowadays, experienced injectors can improve the appearance with a variety of HA fillers that are produced specifically for this purpose. In addition, when a volume deficit in the cheeks is believe to be a contributory factor, this, too, can be addressed leading to improvement. You would be wise to consult with an experienced, board certified cosmetic dermatologist and make sure to ask to see his/her personal before and after photos of filler tear trough treatment before agreeing to proceed. And, finally, exercise a great deal of "buyer beware" caution if offered all kinds of expensive, energy-based gizmo treatments, like fraxel lasers or RF devices, etc., as the hard science to support the use of these "bells and whistles" lags woefully behind the heavy marketing hype and social media buzz that surrounds them--especially since they carry an heightened risk for skin dyspigmentation problems, particular in skin of color. Hope this helps and best of luck.

Zoran Potparic, MD · Answer

Fat volume loss in some areas of the face in particular upper cheek/eyelid junction is part of aging. However, it is seen in patients who have cheek bone hypoplasia (smaller cheek bones) much earlier in their life. Augmentation with fat grafts, cheek implants or fillers, usually accompanied with transconjuctival lower blepharoplasty,  is way to treat this condition. Hope this helps.

Darryl J. Blinski, MD · Answer

As stated above and has seen your photos, you have tear trough deformities, or the sunken under eyes. HA filler injections will improve this issue. The injections last from 3 to 8 months, depending on which type of H filler used. Fees range from $700-$1800. Best to virtual consult with.

What is this sunken skin under my eyes? It looks deeper than skin on rest of my face (Photos)

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