I have grooves under my eyes. Are they eye bags, tear troughs or festoons? What is the best treatment? (Photo)

Question

I have grooves sitting fairly low under my eyes that don't go away. I did some background research and I honestly can't tell if they are under-eye bags, tear troughs, or festoons. I have heard it could be sinus related as well. I know that treatment varies depending on the condition. I am 24 years old and made the poor choice of tanning excessively when I was a teen, but have always taken great care of my skin and avoid sun exposure as much as I can now. I feel like it's too early for this!

Harold J. Kaplan, MD · Answer

Hi EH.  You are a PERFECT candidate for Restylane injections under the eyes.  It's not likely that the grooves are a result of tanning, at least at your young age.  It's more likely they are a genetic issue and can be fixed easily using Restylane.  Find a talented injector in your area that can show you before and after pictures of someone in your same situation.  We would recommend 2 CC's of Restylane to fill the void under the eye and it would likely last about 9-12 months.For before and after pictures of the tear trough injection procedure, click on the link below.

George Yang, MD · Answer

Hi eyehelp121,Tear troughThe first 1 inch of the diagonal groove from the inner corner of the eye is called a tear trough.  Although there is a slight bulge above the tear trough, I would not define your lower eyelid bulge as an eyebag.  A very small volume of Restylane should be able to hide the lower eyelid bulge to blend it smoothly to the upper cheek by your nose.  I have much more extreme examples of true eyebags which I was able to blend smoothly to the upper cheek.Lower orbital rim hollowingThe hollowing around the outer rim of the eye is not called a tear trough.  If there is a slight concavity or almost a fingerprint sized depression between the outer eyelashes to the cheekbone, this can be filled to appear smoother from the eyelash to the cheekbone.  This can give a higher and fuller cheekbone appearance by reducing the concavity under the lower eyelashes.Malar ligament AKA Cheek ligamentA continuation of the tear trough as is travels diagonally across the cheek is called the malar ligament.  If the cheek and lower eyelid tissues are overflowing the ligament, then you can call it a festoon.  Since it is flat above and below the ligament, I just call it a malar ligament.  I like to fill deep below the malar ligament to pop-out the slight indentation of this area of the cheek.Completing the Triad => Apple cheeks.Using relatively small volumes of 1-3 cc's (1 cc is the same as 1/5th of a teaspoon) smoothing out the concave areas under the lower eyelash line can make the cheeks blend more seamlessly to the the lower eyelash line, without creating a bloated, pillow face appearance.I like Restylane for these areas and using a microcannula to inject to reduce the chance of bruising and allows more delicate sculpted result.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

John J. Martin, Jr., MD · Answer

You do have a little prolapsed fat, but mostly you have a deep tear trough from a lack of volume.  You also have a prominent malar fat pad whereby you can see the outline of the pad through the skin.  You should try adding some volume to the tear trough to smooth the transition from the cheek up to the lid.  Belotero or restylane are your best choices for filler in this area.

Mitesh Kapadia, MD, PhD · Answer

Based on your photos it looks like the main problem is hollowing in the area of the tear trough and upper cheeks. I think you could benefit from filler injections in this area. The goal is to blend the eyelid-cheek junction, which should lead to a more youthful, less-tired appearance.

Katherine A. Lane, MD · Answer

from your photos is looks like you have some volume loss which may be in some way related to tanning, but more likely you look like someone in your family. tear troughs and some volume loss in the upper cheek, which it also looks like you have, tend to have more to do with underlying bony structure and soft tissue changes. as long as you don't have allergies which cause swelling around the eyes you would be a great candidate for Restylane injections.

I have grooves under my eyes. Are they eye bags, tear troughs or festoons? What is the best treatment? (Photo)

Answers (5)

Answer: Grooves under eyes

Answer: Grooves under eyes

Answer: Restylane workds great for tear troughs

Answer: Restylane workds great for tear troughs

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

I have grooves under my eyes. Are they eye bags, tear troughs or festoons? What is the best treatment? (Photo)

Answers (5)

Answer: Grooves under eyes

Answer: Grooves under eyes

Answer: Restylane workds great for tear troughs

Answer: Restylane workds great for tear troughs

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.