Q: I am in my early 30s but have had infraorbital hollowness and dark circles since I was a child, & now I have some fatty herniation. I am beyond tired of strangers in supermarkets asking me if I am tired. But, w/so many horror stories of tear trough fillers (on this website & the Internet), why are so many plastic surgeons promoting them? Tyndall Effect is not ok, even for people with prior hyperpientation. Looking for best result answer vs. most cost effective or least amount of down time.

Dr A’s Answer: Answering this without seeing you in person is complicated, however. . .

Typically someone who has hollows under the lower eyelids from a young age is an excellent candidate for a tear-trough implant. Hollows at a young age are very much related to the shape of the skeleton and the implants directly correct that situation. In addition, the fat that becomes visible with age in the lower eyelids can be blended into the upper cheek/implant area during the same surgery. The surgery is done through the inside of the lower eyelid and thus results in no visible scars. Healing is usually sufficiently progressed in about one week to return to work.