Younger patients can benefit from lower eyelid surgery because of familial traits.
Most blepharoplasty or performed is a consequence of aging. Some individuals have congenitally puffy eyes they can be dealt with at an earlier age.
Puffy lower eyes, aeyo-sal effect when smiling
When smiling you have what the Koreans love that is aeyo-sal. It is when the orbicularis muscle is large. However, at rest it looks like to do have puffy eyelids related to fat. In Caucasians who do not like the aeyo-sal effect, I use Botox into the muscle.
You will need the fat removed with a lower blepharoplasty surgery.
Treatment of eyelid bags in a 21 year old
You have prominent lower eyelid bags/fat and hollowness underneath it. You may be candidate for lower blepharoplasty with fat repositioning or filler injection. See an oculoplastic specialist.
Lower eyelid fat
You do have some prolapsed fat. You also have some hollowing in the tear trough. This can be filled in with filler, and should make you look much better for at least a year. If you want to have a lower eyelid bleph, do not have fat removed. This will accentuate the bone below the eye and make the dark circles worse. Find someone who can do a fat repositioning which will move your own fat down into the tear trough. You will get long lasting results from that.
Blepharoplasty for swollen or puffy lower eyelids
Because you're young and appear to have good skin tone a trans-conjunctival lower blepharoplasty may be a good option to remove excess protruding fat and lessen the puffiness of your lower eyelids.
Be aware however that in the smiling photograph some of the bulge that you see is the contraction of your normal lower eyelid muscle. This fullness directly below the lashes seen when smiling will be present even after blepharoplasty fat removal.
Please choose your board certified plastic surgeon very carefully and make certain to Dr. is comfortable doing oculoplastic procedures.
Puffy lower eyelids
A trans- conjunctival approach lower eyelid blepharoplasty can conservatively remove herniated fat in the lower lids. It's important to make sure there is no other medical conditions such as thyroid problems or allergies before undergoing elective blepharoplasty at age 21
Transconjunctival blepharoplasty with or without fat Repositioning for puffy eyelids.
Transconjunctival blepharoplasty with or without fat Repositioning for puffy eyelids is what will give you what u seek. I have done these for more than 35 years and have seen my patients age over that time and often the "aging" bags do not occur.
I am 21 and considering lower lid blepharoplasty
Your photos are inadequate to give you much of an answer, It appears you probably have malar hypoplasia and therefore what we call a negative vector making some types of lower lid surgery very difficult. You need to see someone in consultation for a full exam before any recommendations are given.
First you are probably young enough that lower eyelid filler may accomplish everything you need.
This type of service is fussy and you very much need someone close to home who do a fantastic job. These treatments typically last about 2 years.
If you went with surgical treatment, the best option is most likely transconjunctival lower blepharoplasty with arcs marginalis release. This takes the fat in the lower eyelid and shifts to the top of the cheek. You will love the effect of this surgery. Now, here is the thing, no every surgeon is put together the same. This type of surgery in my opinion is best performed by a fellowship trained oculoplastic surgeon with a large focus on eyelid aesthetic surgery. That might be impossible to find close to home. Do not get talked into transcutaneous lower blepaharoplasty. That will pull your eyelids down and make you regret the decision to have surgery.