The primary goal of lower lid blepharoplasty is to remove the puffiness caused by herniation of the 3 fat pads in the lower lids. This is done thru an incision on the inside of the lower lids known as a transconjuctival approach The secondary goal is to tuck a conservative amount of skin pinch on the outside at the lash line when needed. The lash line incision is closed with tissue glue, not stitches. This is performed under a brief general anesthesia for patient safety and comfort
I Have Bags Under my Eyes on I'd Like to Know What Can I Do to Fix Them?
Doctor Answers (10)
Surgery for bags under the eyes
A very common aging change in the lower eyelids is the development of 'bags', which are in most cases due to an outward bulging of the fat pads behind the lower lids. These 'bags' of fat can be improved by conservative removal through an invisible incision on the inside of the lower lid (trans-conjunctival approach) in patients that do not require skin excision, or through the under-eyelash (sub-ciliary approach) in patients that are having some excess lower lid skin removed.
As with skin removal, I believe that the reduction (NOT total removal) of lower lid fat pads should be conservative. Excessive removal of lower lid fat pads results in a hollowed-out appearance that makes blepharoplasty patients look tired or even ill. I see quite a number of eyelid surgery patients who require structural fat grafting of the lower lids to improve that very problem following an over-aggressive lower blepharoplasty in the past.
In some case lower lid 'bags' can be improved by repairing or reinforcing the soft tissues that normally hold them back. Additionally, excessive lower lid fat can sometimes be mobilized and transposed inferiorly to fill in periorbital hollows or depressions such as the 'tear trough' at the medial junction of the lower lid and cheek.
Many Options For Eye Bags
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Lower eyelid bags
In the past surgeons removed lower eyelid fat in virtually all patients with
"bags" under their eyes. Our understanding of lower eyelid aging has evolved in recent years. While their is no consensus, most surgeons would agree that there are various treatment options and that the care must be individualized.
Fat removal or transposition is a wonderful procedure for those with either excess fat or in need of a better distribution of fat. Fillers include the new filler recently approved by Merz pharmaceuticals will soften contour issues and create a smoother profile in many patients.
In the end it is necessary to learn the pros and cons of each approach and understand what you ultimately wish to achieve.
Bags under eyes, eyelid bags
Restylane or Radiesse are two good filler options.
Fat grafting can result in longer lasting results 2/3 of the time.
Blepharoplasty is the gold standard treatment with results lasting many years.
The Cellulaze Sidelaze can be used to melt the fat pads as well.
Please consult with a Board Certified Plastic Surgeon in person prior to making any treatment decisions.
Bags under the eyes are a very frustrating problem! While many creams promise to help reduce their appearance, they simply can't change the fact that eye bags are an anatomical problem and can't be addressed with something topical. Instead, you could try camoflaging the bags with a filler like Radiesse or Restylane. Or, you could see a plastic surgeon for a blepharoplasty, a procedure where the fat pad under the eye that is causing the bag is removed through a tiny incision on the inside of the lower eyelid. You can learn about both of the options on the links below. Best of luck!
Treatments for bags under eyes
A picture would be helpful to give you detailed advice, but there would basically be two options to help with bags under the eyes. You could have surgery to remove some of the fat or you could have an injection of a hyaluronic acid (Restylane, Juvederm, or Belotero) under the bags to help hide them.
The procedure that will give you the best and longer lasting results would be the blepharoplasty (eyelid lift). You do have other options but it all depends on what kind of results you are looking for.
Lower Eyelid Bags
Lower Blepharoplasty surgery is the best procedure for lower eyelid bags. You have 3 fat pockets that need to be excised. Also, at the same time any excess skin is removed. Consult with a Board Certified Plastic Surgeon to discuss your expectations and concerns. Best of luck to 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.