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28 Years Old With Eye Bags - Eyelid Surgery Only Option?

I am 28 years old with eye bags. I am interested in what cosmetic procedure could help get rid of them. Is eyelid surgery my only option?

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18 Doctor Answers | Asked by jazbow in Tennessee

Doctor Answers (18)
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Option for eye bags.

We do not recommend injections around the eyelids due to complications we have seen in patients from other offices. We recommend a transconjunctival blepharoplasty to remove the lower lid fat pads so that there are no external incision.

Treatment of dark circles under lower eyelids

Dear Jazbow, From your photo your lower lid deformity has two components. I believe that there is an exaggerated length between your pupil and lower eyelid-cheek junction. There has been an explosion of experience adding volume to help elevate the eyelid-cheek junction. There are no perfect fillers but there are many which could help improve your lower eyelids which has less downtime and risks than operative intervetion in an office setting. ... more

Eyelid surgery would definitely not be a good option for you

From the photograph, it looks like the muscle under the eye at the lashes (the obicularis muscle) looks thickened and the area underneath it looks hollow. The dark circles are a combination of this muscle being thicker than normal (which some people are just born that way - and this can be relaxed with a little bit of BOTOX), and the area under the eye which is hollow from a lack of volume, which may be due to the way the bone structure in the face. Eyelid surgery would... more

Eye Bag Treatment

What might appear to be a large bag near the lower lid is often caused by an underlying depression or shallow area that catches shadow when light is coming from overhead. This is particularly true in young folks like yourself as the aging process has not yet begun to distort youthful anatomy. The attached photo is difficult to discern, but nonsurgical procedures such as hyaluronic acid filler injections can often help immensely. Once the topography and shadowing are... more

Lower Eyelid Bag Treatment Options

Hi jazbow, Thank you for sharing photographs. Generally, there are a few options to improve the appearance of the lower eyelids, eye bags, or dark circles. First option includes basic skin care, tretinoin, and/or chemical peels. This nonsurgical method helps improve the skin quality, reduce pigmentary changes, and improves overall appearance of the lower eyelid & cheek areas. Second more advanced option is an injectable filler or fat to plump up the area. Fillers are... more

Do I need eyelid surgery or fillers?

Though it is tough to say with only one photo, I would consider a filler injection in the the hollow under the eyelid. this is low risk, minimally invasive, and often very effective in younger patients.

Lower eyelid depressions

I often will inject restylan under the eyes for minor depressions in young patients such as yourself, but it is hard to say from one photo. An exam is key.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Restylane is great for under eyes.

Hi. You seem like an ideal candidate for this. It's just tricky technically, so go to some one with experience. The Restylane should be injected deeply under the muscle and in tiny quantities.

Based on your photo, your lower eyelid bags may be improved by a well-performed Injectable Filler treatment. Video attached.

I read your concern and reviewed your photos. In my practice, I nearly always suggest a non-surgical approach for improving the appearance of lower eyelid bags. You appear to have typical grooves between your lid bags and your cheeks that would benefit from a well-performed filler treatment. In my view, you should avoid fat removal from your lower eyelids which may result in a hollow, "operated" appearance. I attached a link to a photo demonstrating non-surgical lower eyelid... more

Eric M. Joseph, MD

197 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Would recommend that you consider Restylane filler.

You are young and the lower eyelid fullness is minimal. It is likely that you will do very well with just lower eye filler. If you decide you don't like the need to repeat the service, then the alternative would be lower eyelid surgery in the form of an arcus marginalis release.

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Non-surgical treatment of bags under eyes

In your photo I see a small lower eyelid fat bulge near the nose on the right, lower eyelid muscle bulges just under the lower eyelashes, troughs at the lower eyelid cheek junctions and darkened lower eyelid skin pigmentation. The aesthetic goal in lower eyelid surgery is to make the cheek lower eyelid junction less noticeable so it is harder to see where one begins and the other ends. In your case the best way to achieve that is to lighten the lower eyelid skin color. Additional benefit... more

If it were me, I would choose surgery.

The transconjuctival removal of fat will permanently fix your problem. The use of injectable fillers sounds easy but sometimes can give a "ground glass" appearance to the tissues lying just superficial to them. Fillers are not permanent but, in the upper cheek/lower eyelid they tend to stay around for much longer than elsewhere (1-2 years).

Fillers can help

Although removal of fat via a blepharoplasty is an option in some patients, in your case, it would not be prudent. Your degree of prolapse is mild. Fillers [Juviderm or Restylane] will improve the appearance as it will blend the eyelid to cheek transition. But on close inspection of the photo you provided, it seems to me that hyperpigmentation of the eyelid skin is also a major contributing factor. Unfortunately , this will not be addressed by fillers, and at this time, besides concealers,... more

A.J. Amadi, MD

14 reviews

Seattle Oculoplastic Surgeon

seattleface.com

Lower eyelid "bags"

Surgery is not your only option. In fact, a better option for you is using injectable fillers into the "hollowness" under the "bags". It is safe, predictable, and effective. Dr Taban

Injectable Filler for Tear Trough Eyelid Hollows

Good news!! Based on your photograph, you appear to have hollowing of your lower eyelid rather than eyelid bags. The treatment for this problem is nonsurgical and requires filling in the hollow area with an injectable filler such as Restylane. Restylane consists of hyaluronic acid which is also found in your body and is used to fill in the hollowed areas which are also referred to medically as the tear trough. If you have dark circles under you eyes, this non-surgical approach can... more

Lower Eyelid Surgical and Non Surgical Options

From your photo, it does appear that you have excess fatty bulge from the lower eyelid, and this is made worse with overhead lighting. A transconjunctival fat removal procedure is a permanent solution to this but not you only option. One must be careful to not over remove fatty tissue which can lead to a "hollow" lower eyelid appearance. Thus, fillers such as Restylane can be a useful tool which can be easily done in the office. Speak with someone who is experienced in this area... more

Eyelid options at age 28

There are a few individuals who may require a transconjunctival eyelid procedure for inherited or familial fat bags, most will not a such a young age. Your photo demonstrates pigmentation issues and shadow within the lower lid which mimics a prominent fat pocket. Your options should include concealers, and injection of HA fillers, or fat fill into the lid hollows. We like the fat transfers the best. Best of luck, peterejohnsonmd

Non Surgical Option for Under Eye Bags

Jazbow, A great nonsurgical option for under eye bags is the injection of a filler such as Restylane. The filler can be injected under the prolapsed lower lid fat to disguise it. This is an in office procedure that should take less than 30 minutes.