Eyelid Surgery: Q&A

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Should I Get Blepharoplasty or Filler in the Tear Trough?

I am 25 and I have bags under my lower lid and i hate them! I have seen few surgeons in London some said Blepharoplasty or Filler in the Tear Trough? I am really confused what I should do! This is genetic and my mum and dad have them as well also few other member of the family has them too! Can you please suggest me what is the best option for me! thanks

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13 Doctor Answers | Asked by ellie25 in London, nw

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Filler does not effect lower lid fat!

Lower lid surgery can reduce and transpose fat into the tear trough producing a long term correction. Fillers injected into the trough camouflages the protruding fat is temporary, although swelling can be prolonged if over corrected. In your case my recommendation is lower lid surgery.

Should I get Blepharoplasty or filler for lower eyelid bags?

Fillers will hide the leading edges of the lower eye bags but only a lower Blepharoplasty can remove these bags permanently. At 25 years old, you have a long time ahead of you to use temporary fillers...you might consider the Lower Blepharoplasty to remove the bags once and for all.

What to do for lower lid bags

Without pictures, it is difficult to say for sure what would be best for you. In all liklihood, either would work. A filler would have to be repeated, whereas surgery would be more permanent. In my experience, with younger patients with familial lower lid bags, a transconjunctival approach works very well. This is done from the inside of the lid and leaves no visible scar. Fillers in the lower lids tend to last longer than in other areas, usually at least 12 months and... more

Blepharoplasty vs Filler injections

Reading through the postings just about everyone has asked for a photograph. There is a good reason for that. In many patients this is really a judgment call. There are patients who are borderline and would profit from either one. Obviously the filler injections are temporary whereas properly performed lower eyelid surgery done from the inside without a scar in a young person can last you the better part of your adult life. It sounds like this is really a family trait and without seeing... more

Blepharoplasty vs. tear trough filler.

I would need to see photos and then I could easily answer your question. In general if you have bags in the lower eyelid the best way to treat them is by removal. Fillers are in patients with tear trough and from your age I doubt it that is you!

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Options for surgery vs injectable fillers

To make this choice of necessity would be a careful clinical exam to determine what the problem is: it sounds like you likely have a familial excess fat which would respond well to a lower lid blepharoplasty ( I like to perform these through a "subconjunctival" approach i.e. on the inside of the lower lid) this would alleviate a scar and the excess fat could either be removed or repositioned or both. Fillers have their place but are less long lasting that the surgery (when... more

Lower Lid Surgery vs Filler Injection

Ellie, Whether you have lower lid surgery or filler injection will depend upon: 1) Your anatomy. At your age, you probably have fat prolapse and not excess skin, so either procedure will work. 2) How much risk you are willing to accept. Every procedure has some risk. Lower lid surgery has a low complication rate, but it is slightly higher than the complication rate for fillers. 3) How long you would like the procedure to last. I tell patients that... more

Michael McCracken, MD

8 reviews

Boulder Oculoplastic Surgeon

In most patients, a well-performed Injectable Filler treatment may be best to improve the appearance of your lower eyelid bags.

It's difficult to advise you without seeing a photo, but most young patients like yourself with lower eyelid bags may benefit from an Injectable Filler treatment. I almost never remove lower eyelid fat anymore since this may lead to a hollow, "operated" appearance. My personal preference for "tear trough" filling is to use Silikon-1000, an off-label filler for permanent results. I hope this is helpful for you. Regards from NJ. see video

Eric M. Joseph, MD

199 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Lower eyelid dark circles

The answer depends on exactly how your eyelids are in relation to the relative "bags" and relative "hollowness" underneath it. It also depends if you want something more longterm (surgery) or something less invasive but short term (fillers).

Lower eyelid surgery is indicated for excess fat

It sounds like you have excess fat in your lower eyelid area which is likely genetic. This fat typically needs to be repositioned (not removed) in order to restore a natural lower eyelid/cheek contour. This is usually done through an incision on the inside of the lower eyelid (transconjunctival). A board certified plastic surgeon can explain this to you in greater detail during your consultation. Fillers are only useful for filling in tear trough areas, not for lower eyelid bags... more

For familial lower lid bags in young patients, surgery is best.

Hi. Because you are young, and because it runs in your family, you probably have a true herniated excess of fat in your lower eyelids which can be permanently corrected with a skilfully done trans conjunctival (scar less) lower eyelid plasty. This is not related to aging.

Lower eyelid fillers vs. Blepharoplasty

There are two main reasons why a person has lower eyelid bags. One is that there is too much fat in the lower eyelid. The other is that there is an absence of fat in the cheek just below the bag. Excess fat is best treated with surgery and too little fat in the cheek is best treated with fillers. Some patients have a little of both problems and either option might work well. It would be very helpful to have photos. My suggestion is that you... more

This is a difficult choice

Fillers generally need to be repeated somewhere between every 6 months and every 18 months. Every injection involves expense and risk of bruising and asymmetry and lumpiness. Surgery should last for many years but also involves risk. Some surgeons will recommend what they do best, surgery or filler, which may not be what is best for you. I think you should consider the different pathways and see what feels right for you, and pick a doctor who can show you pictures of someone with... more