How can I fix the bags under my eyes? Lower bleph? (Photo)

From the photos provided there does appear to be a deepening of your tear trough and naso-jugal groove. There is also lower eyelid skin excess. These issues can be improved with lower eyelid (blepharoplasty) surgery. It is worth mentioning that the mid face is closely linked with the lower eyelids. During aging, the mid face fat commonly descends, which contributes to the features seen around the lower eyelids. Very commonly the mid face is also addressed with lower eyelid surgery to improve the overall cosmetic appearance to this area. In addition, as part of the aging process, the upper eyelids tend to have skin excess. It is important that you are assessed for this, so that you have the best outcome in terms of facial rejuvenation.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Your photograph is limited. However, you may benefit from a browlift to help the upper eyelids. You may also benefit from an upper and lower blepharoplasty. You may also need a mid facelift for the excess skin around your eyes. More photographs are needed to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.