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Am I A Candidate For Blepharoplasty For Bags and Hollowness? (photo)

I'm a 29 year old male with under eye issues. Around the age of 18 I began to develop bags under my eyes that in some light appear to be hollow or white. I've tried restalyne twice, with little success. I think the restalyne would be affective for me if I were injected with a very large amount, but I cant justify paying every 7 months. Recently I've seen two surgeons who've recommended a transconjunctive blepharoplasty, but I worry that my eyes will just become more hollow. Thanks

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age 25-34 hollowness effective second opinion

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17 Doctor Answers | Asked by BobfromIowa

Doctor Answers (17)
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Blepharoplasty for a young man

You have excess fat bulging through the medial and middle orbital septum. Your surgeons' recommendation of a lower lid blepharoplasty is a good one. There are two approaches - transconjunctival that trims the excess fat from inside the lid. Standard blepharoplasty that uses an incision under the lashes. This allows full release of the orbital septum, very careful trimming of the excess fat so it lies smooth with the muscle and re-positioning of the... more

Concerned with the lower eyelids

Your concerns are justified. As a general rule, the hallmark of healthy, young looking lower lids is fullness. Overall, you do have a congenital lack of lower lid fullness, meaning that if anything is done to the lower lids you need to be very careful about creating a hollow look. Unfortunately, while you do have an overall lack of fullness, you also have a small area of fat that projects forward in your lower lids causing a tired look. Filler has been unsuccessful because you are not... more

Blepharoplasty for bags under eyes

Removing the fat in the lower lids creates more of a natural contour with both muscle and skin without the puffiness present. A lower blepharoplasty is performed under a brief general anesthetic as an outpatient procedure.

Fat repositioning

Fat repositioning would be a better option for you than simply excising and removing the fat. In addition, I have often used fat grafting to the eyelid cheek junction to help further camouflage the eyelid fat. This technique is much more advanced and extreme care has to be taken to avoid creating additional lumpiness. It has to be subtle amount of fat added. If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can... more

A.J. Amadi, MD

14 reviews

Seattle Oculoplastic Surgeon

seattleface.com

Lower Eyelid Surgery for Under-Eye Bags

Fixing the problem with the puffiness below your eyes by "masking" with Restylane filler is a temporary solution and you seem to be looking for a more permanent fix. You may be a candidate for lower eyelid surgery should you elect to have the fat removed surgically. Because hollowness is also an issue, you may want to do a comprehensive procedure in repositioning fat. As an oculofacial cosmetic surgeon in New York for over 15 years, I strongly recommend you consult with a qualifies... more

Blepharoplasty

Yes, it appears that you do have some herniated fat. Sometimes releasing the ligament along the lower lid during a transconjunctival( inner lid incision) blepharoplasty can improve this area as well. The tear trogh area can be difficult to soften without filler. Good luck.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Balance avoids hollowness after blepharoplasty

When it comes to blepharoplasty, it is about balance. More is not necessarily better. The goal of transconjunctival blepharolplasty is to reduce bulging fat in the lower eyelids. Removing too much fat can produce hollowness but an experienced surgeon will be able to balance the amount of removal to avoid this. That being said, traditional blepharoplasty does not improve the tear trough or demarcation line between the lower lid and cheek skin. Advanced... more

Blepharoplasty for lower lid bags

A transconjunctival lower eyelid blepharoplasty would be ideal as you have good lower lid skin tone, just inherited bags of fat coming forward from the eye socket. Repositioning some of this fat into the tear trough would create a very youthful contour to the mid-face.

Matheson A. Harris, MD

6 reviews

Salt Lake City Oculoplastic Surgeon

www.utahoc.com

Transconjunctival lid rejuvenation is the answer

Familial or inherited bags in the lower lids will respond very well to a tranconjunctival blepharoplasty, and if done well, future lid hollow can be avoided. The 'hollow' that you see is due to overhead light and shadow which accentuates the bags. Women will mask things with cosmetics but men can't bother.

Blepharoplasty at age 29

I am in total agreement with the other consultants who have advised a transconjunctival blepharoplasty with fat repositioning. I've been doing the procedure for many years and have very happy patients. Just make sure you have a surgeon that is quite experienced in the technique, as not all surgeons use this approach.

Blepharoplasty with fat transfer for hollows.

For 35 years I have used blepharoplasty to rove the excess fat in the eyelids and sewing that fat into the hollows.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Lower lid bags

Restylane or Juvederm should last 1-2 years at least. Best results would come from transconjunctival blepharoplasty with fat repositioning, minimal fat resection. I appreciate your concern but done right, it will not look hollow. Thank you for the good photos.

Am I A Candidate For Blepharoplasty For Bags and Hollowness?

The photos show the presence of fat bags of the lower eyelids that could be addressed with lower eyelid surgery.

Classic situation for transconjunctival arcus marginalis release surgery.

This procedure preserves the lower eyelid fat and uses it to fill the tear through hollow. As an alternative to lower eyelid surgery, you could have lower eyelid filler to fill in the gap between the lower eyelid fullness and the tear trough hollow.

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Fat repositioning may be the best approach

Given the appearance depicted in the posted pictures, I would approach the lower Blepharoplasty through a subcilliary incision and attempt to reposition or redrape the infra-orbital fat into the deep tear trough defect and over the infra-orbital rim to creat a smooth and youthfully full appearance as opposed to excising the fat and risk creating a cadaveric or hollowed oribital appearance which is difficult to correct later. The most important consideration is consulting with qualified,... more

Candidate for Blepharoplasty

Transconjunctival Blepharoplasty can lead to excellent results in the right hands. Conversely, it can lead to hollowness, if overdone. This may be the best approach, combined with volume augmentation (Sculptra) or use of a permanent implant. It is always best to seek more opinions if you aren't convinced.

Am I A Candidate For Blepharoplasty For Bags and Hollowness?

Thanks for the excellent posted photos. Best to seek additional consults because you have issues with the surgery and hollowness. I recommend the transcend. than allow healing for 3 months. If hollow than add filler.