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Candidate For Transconjunctival Blepharoplasty or Restylane Filler?

asked 8 months ago by framboiise in washington
Latest answer by William Portuese, MD
Question viewed 639 times
Tags: age 18-24, female, front view, candidate, comparison, glasses, pros and cons, puffy eyes

I am 24 years old and suffer from under-eye puffiness. I'm in dire need to correct this situation in order to restore my youth and happiness and not hide behind my glasses as I've been doing for years.

Am I candidate for the less evasive Restylane filler? Or would you recommend full Transconjunctival Blepharoplasty? or im to young for this ? List Pros & Cons, Advice you can offer others.

17 answers to Candidate For Transconjunctival Blepharoplasty or Restylane Filler?

Am I a candidate for Transconjunctival Blepharoplasty?

From the photos you do appear to have lower eyelid fat bags. These would be reduced wioth a transconjunctival Blepharoplasty...you may want to have a few consultations to explore your options.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Too Young for Under Eye Bags

All other things being normal on your exam, I would opt for the transconjunctival blepharoplasty. I am usually not so adamant with my answers but from your story and photos it does seem like your under eye bags are more of a hereditary problem rather then aging. If your cheekbones are flat I would consider fat grafting as well. Personally, I do not like the results from filler in this particular situation. Further, you will be potentially be getting... more

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon

www.vargasfaceandskin.com

Oposite treatment

Your problem is very complex, transconjuctival blepharoplasty will remove volume, filler injection will add volume!!! as you can see, this does not make too much sense. Neither one of these options is the best, you can get partial solutions with either. This is usually a familiar trait, most of the time patients like you also have loose skin in the lower eyelid, this can only be determined with an examination. There are 3 key components on examining your problem, excess fat (bulging... more

Victor Manuel Perez, MD
Kansas City Plastic Surgeon

Restylane or Eyelid surgery

Before I decided, I would see an eyelid specialist (oculoplastic surgeon) and a dermatologist or plastic surgeon. The reason is that an oculoplastic surgeon can tell you whether removing the fat pad will provide you with the result you are looking for and also consider some other factors before treating you. A good plastic surgeon can do the same thing. However, a dermatologist usually does not perform this surgery so wont be able to give you the pros and cons for that aspect of your... more

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon

T-c v. restylane

Yes and yes. the bleph is ideal for lowering the fatty bulges. restylane would be useful for your nasojugal creases. so you may benefit from both. start with the bleph though because it is an immediate long term result. good luck.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Take your time making decisions where advice is sketchy.

Age 24 and already hiding behing glasses............sounds like you have a congenital or familial problem and in these cases correction doesn't have to wait any longer than reaching adulthood(say age 19). I'm not sure from the photos (thanks for them by the way as we really need to see photos to be able to answer properly) but it looks like you need fat reduction from the lower eyelids for sure. Padding the lower groove below the fat protrusion with a filler (Restylane or anything... more

Harlow Hollis, MD
Victoria Plastic Surgeon

You may be a candidate for a well-performed Injectable Filler procedure to minimize the appearance of your lower eyelid bags.

I read your concern and reviewed your photos: You appear to have fairly typical lower eyelid grooves that are between your lid-bags and your cheeks. Artfully placed filler in these grooves may diminish the appearance of your lower eyelid bags. You must be certain that your doctor is familiar with the delicate art of injecting lower eyelid skin, as this area may be unforgiving. I prefer using Silikon-1000, an off-label filler for permanent results, when filling lower eyelid grooves. In my... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

Under Eye fillers or Surgery

It's a little hard to tell from your pictures what would be right for you. I would say there is absoloutely no harm in trying some volume filling under the eyes at this oint. Just be sure to find someone with a lot of experience doing this. If this is unsatisfactory, you can always opt for a surgical correction at a later date. A personal consulation with a cosmetic physician would be best to help with your decision.

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon

Subconjuctival Blepharoplasty for lower eyelid bulges

Age 21 is a bit young to be considering lower lid surgery, however, judging from your photos, you do have signifigantly protruding fat pads. The fat pad bulges are not related to body weight, but are usually a familial trait which becomes more pronounced over time. A subconjunctival blepharoplasty would result in removal of the fat pads without skin incision or scarring. The fat pads generally do not regrow, so results are relatively permanent. In evaluating... more

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon

Transconjunctival Blepharoplasty

Hi, Regardless of age, some patients suffer from congenital or familial lower lid fat herniation. From the pictures below you are good candidate for transconjunctival Blepharoplasty. I don't think that fillers will give you the results that you are looking for. Best, Dr.S.

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

Lower lid bags

To give you a recommendation would require a full examinination and analysis of photos, particularly of lateral views. However, your anatomy, not your age, will dictate whether you need surgery. A transconjunctival blepharoplasty has immediately solve problems with excess fat causing bags if that is the case. However, that does not mean other aspects of your anatomy might prevent complete correction without other procedures. Fillers can be helpful but must be done very, very carefully and... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Fillers vs blepharoplasty

At your young age it would ne nice to avoid surgery if possible but sometimes a transconjunctival bleph is needed for congential lower eyelid fat herniation. Your photos are all looking down so a true statement can't be made without you looking straight forward. Restylane is very useful in the tear trough if the fat herniation doesn't project out too far.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Candidate for blepharoplasty or filler

Puffiness underneath the eyelids at a young age can be related to thyroid disease or allergies. It is important to make sure that both of these medical conditions are addressed by your family physician. If it is still persistent, a transconjunctival lower blepharoplasty can be performed whereby the fat is removed from the inside of the eyelid. This procedure is done under a brief general anesthetic. We do not recommend fillers along the eyelids due to the multiple... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Stop,Look,Listen

No surgical plan should be developed by any surgeon, until good quality photos are provided. The patient should be photographed with the usual 5 views of full face while the head is in a horizontal position. Lateral views of the orbital area, as well as , a worms eye view of the orbital rim area should also be examined for a negative vector condition.Only,with these views a plan could be developed. It would take a pretty severe condition that would justify operating... more

William D. Merkel, MD
Grand Junction Plastic Surgeon

Transconjunctival Blepharoplasty In Young Patients

Occasionally patients in their early 20's are good candidates for a lower lid blepharoplasty. Their deformities are typically familial. I recently had the opportunity to see a patient (for another concern) on whom I had performed a lower lid blepharoplasty 20 years ago when she was in her early 20's. Her result was still quite good 20 years later.

John Whitt, MD
Louisville Plastic Surgeon

Under Eye Rejuvenation

With each passing year I find myself performing less 'invasive' lower lid surgery (i.e a formal lower blepharoplasty) and more lower lid rejuvenation by means of structural fat grafting. The reality of aggressive lower lid surgery - which involves some combination of skin excision, fat pad reduction and/or fat pad transposition, orbicularis (muscle) redraping and excision, and canthal support (to hold up the lateral aspect of the lower lid while everything heals) - can easily... more

Michael Law, MD
Raleigh-Durham Plastic Surgeon

michaellawmd.com

Restylane vs. Tranconjunctival Blepharoplasty for Lower Lids

In my hands, I would recommend a tranconjunctival bleph to treat your lower lid fat herniation. I think this is a safe procedure with minimal downtime in the appropriate patient. Most patients are able to return to normal activities by 1 week. In addition, the result will last for many years, compared to restylane, which may last 6-12 months in this area. If you choose the filler route, please be careful and selective on the surgeon who performs this procedure.... more