This tear trough with or without a fatty bulge can create a shadow under the eye in certain lighting that can create the appearance of tiredness. These features can be associated with a degree of pigmentation (darker skin) and also swelling around the eye (Periorbital swelling).
The eye area has to be assessed by Dr Rory closely as many of the conditions discussed may coexist and so treatment must be tailored specifically. Non-surgical approaches range from Juvederm fillers to correct the tear trough to pigmentation treatments or approaches to reduce swelling around the eye. Often, the temples and cheeks require treatments to help reduce the appearance of the tear through.
Surgical treatments range from lower eyelid surgery (Blepharoplasty) to resurfacing of the skin and can be used in combination.