The under-eye area is one of the first places to show signs of aging and fatigue, and treating it requires a delicate balance. Overdoing it with fillers or aggressive treatments can lead to an unnatural, puffy appearance while doing too little can leave you frustrated with persistent shadows, fine lines or skin laxity.
Long Island, NY dermatologist Kally Papantoniou, MD emphasizes a layered, strategic approach to under-eye rejuvenation that restores and enhances natural beauty without overcorrecting. “The goal is always a refreshed, natural look,” she says. “It’s about restoring what’s been lost while keeping the results seamless.”
If Hollowness Is a Major Concern…
A thoughtful treatment plan takes multiple concerns into account. If hollowness is making you look tired, a small amount of hyaluronic acid filler can restore lost volume and soften shadows. But filler alone isn’t always the solution. Many people assume it’s the fix for dark circles and thinning skin when, in reality, the right treatment depends on the underlying cause.
Dr. Papantoniou recommends platelet-rich plasma, or PRP, for patients dealing with dark circles and skin laxity. “PRP helps by boosting circulation and stimulating collagen production over time,” she explains. “It strengthens the skin and improves tone gradually.”
If Wrinkly Texture Is Present…
Fine lines and crepey texture need a different approach. Ultrasound-based treatments like Ultherapy target deeper layers of skin, triggering collagen production and firming the area over time. Microneedling with radio frequency works at a more superficial level to refine skin texture, smooth fine lines and improve overall firmness.
While in-office procedures provide both instant and long-term benefits, a good skin care routine helps maintain and enhance those results. Hydration is essential for keeping the under-eye area looking smooth and plump. Dr. Papantoniou also recommends her Simply Dermatology Eye Cream ($110) which contains peptides, antioxidants and hydrating ingredients to visibly reduce puffiness, fine lines and dark circles.
For Under- Eye Brightening…
Brightening ingredients like vitamin C and niacinamide can help even out skin tone and reduce discoloration while a gentle retinol smooths fine lines. Since the under-eye area is so delicate, it’s important to introduce retinol slowly and use one that’s formulated specifically for this area.
Sunscreen is also a must for protecting the skin and preventing further aging. “Sun damage accelerates collagen loss, which can make dark circles and wrinkles more pronounced,” Dr. Papantoniou says. “Protecting the skin daily helps maintain results.”
Patients who want to maintain a fresh, bright look between treatments can incorporate cooling eye masks to reduce morning puffiness. A high-quality eye cream with firming ingredients keeps the skin smooth and hydrated. Some patients also see benefits from at-home tools like chilled facial rollers or devices that enhance circulation.
How to Avoid Doing Too Much
When it comes to treating the under-eye area, less is often more. One of the most common mistakes Dr. Papantoniou sees is overfilling with hyaluronic acid. “Too much filler can actually create puffiness instead of a youthful look,” she says. “Another mistake is focusing only on volume loss when dark circles, fine lines and skin quality also need attention.”
A subtle, layered approach is the key to natural-looking results. Filler restores lost volume, PRP strengthens and brightens the skin, Ultherapy lifts and tightens and microneedling with radio frequency smooths and refines. Skin care keeps everything looking fresh between treatments. By combining the right treatments and products, patients can achieve an under-eye look that is smooth, bright and youthful—without overdoing it.
