I am 33 years old, and the bags under my eyes make me look older. It seems they bring down my whole face. Also, my left eye is starting to droop, and therefore that side of my face seems to be sloping down. What is the best procedure(s) to restore a more youthful look?
Best Bags Under Eyes Treatment?
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Treatment for Facial Asymmetry
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Surgery may be needed for bags under eyes
My recommendations are completely different. Before one recommends what could or should be done, the current condition needs to described or diagnosed.
From the photo, you can see facial asymmetry that goes down to the level of the bones and contributes to the eyelid appearance. The outer corners of the eyes should be 2 mm above a plane defined by a line joining the inner corners of the eyes. In your case the right outer corner is where it should be but the left is below this plane. That makes the outer half of the left lower eyelid margin droop slightly downward and outward. Because of this there is only 1 bag on the right due to protruding fat (psuedoherniation). On the left there is an upper bag of muscle and a lower bag of bulging fat. No amount of chemical peeling or lasering of the surface skin will correct this. In my opinion there is little or no excess eyelid skin but the degree of excess at this level can only be discerned during a face to face examination
My recommendation would be to try and raise that left outer corner of the eye, remove the covering under the skin and over the bulging fat and suture that fat to the deeper cheek fat in order to camouflage the line you see in the photo that demarcates where the eyelid ends and the cheek begins (nasojugal groove). The muscle under the 1st bulge on the left may need to be thinned and any excess skin found at surgery should be removed.
Great treatment for Lower Lid Bags and a "Tired Look"
The "BEST" treatment for lower lid bags and a Tired Look is NOT one treatment but several treatments.
I would first recommend you have a "Weekend Peel" Sciton Joule ER;YAG Laser resurfacing of the lower lid. Which would in most cases allow you to have the procedure on a Thursday and return to work on Monday. It will tighten the lower lid skin and VASTLY reduce skin looseness and bagginess. Once the swelling is gone in less than a week, I would fill the Tear Troughs which contribute to this look with Restylane smoothing this arch like depressions.
These two treatments would greatly improve the appearance of the eyes.
Dr. P. Aldea
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Topical Cream for Under Eye Bags
Two topical alternatives which are interesting because of their immediate and oftentimes impressive results are NeoTensil and Instantly Ageless. NeoTensil is difficult and slow to apply and has a high price point. Instantly Ageless from Jeunesse is equally effective with a much easier application process and a much lower price point. For those patients who are bothered with lower eyelid bags and are not ready for surgery, this product can be very helpful.
Lower Eyelid Procedure best option
Best treatment for under eye bags
Eyelid bags and facial asymmetry
If a more permanent, invasive solution is something you are interested in, a blepharoplasty and repositioning of the outer part of the left eye is a good option - this can correct the tear trough, skin, and eyelid position at the same time. Your best bet is to see a board-certified plastic surgeon in your area and discuss your options after a thorough examination.
Best Treatment for Under Eye Bags
Thank you for the great question and the photos. With the eyelid issues you are describing, a lower eyelid lift may be a great option. In my practice, I use an extended approach with fat transposition. This technique uses the fat bags that are already under the eyes to fill in the hollow areas between the eyelid and the upper cheek. Then, the midface tissue is elevated and the excess eyelid skin is removed. The combined effect is a natural-appearing rejuvenation of the whole lower eyelid and cheek region. Best of luck moving forward!
Injectable Fillers work well for reducing the appearance of lower eyelid bags.
You appear to be an excellent candidate for an Injectable Filler treatment to your lower eyelid grooves (tear-troughs). I almost never remove lower eyelid fat anymore, since you can end up with a hollow, operated appearance. You should consult a dermatologist or facial plastic surgeon experienced with filling this delicate, and unforgiving area. See attached photo.
I agree, you have mild ptosis (droopiness) of your left upper eyelid. You should have this evaluated by your ophthalmologist. Surgery to correct this droopiness is best performed by a surgeon experienced with ptosis repair: usually an oculoplastic surgeon.
I hope this is helpful for you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.