Hi there, Wondering if Juvederm would be best to go for, I would like my under eye area less "baggy" as it is dark and puffy and ages me. If I don't put concealer on, I look as if I haven't slept for weeks! I would also like to have some Juverderm fillers inmy cheeks to give me some definition to my cheeks and fill those out and some botox on my forehead to raise my brows. Can anyone advise? This picture is actually quite flattering to how I usually look (In my opinion!)
Would Juvederm Help My Dark and Puffy "Bags"?
Doctor Answers 7
Lower lid fullness
From the photo, it appears that you would benefit from a lower lid blepharoplasty to remove the bags and lateral canthopexy to change the angle of your eyes. You would also benefit from an endoscopic lateral brow lift or Botox injection to the lateral brow to achieve a lift. With these procedures, your eyes will appear brighter and you will appear less tired. Good luck.
Don't forget the ptosis!
Personally, I am not a big fan of HA fillers, like Juvederm, to camouflage lower lid bags. Sometimes it causes more swelling and patients can actually look worse. I would advocate lower lid blepharoplasty with conservative fat sculpting.
Just as important to your appearance is the drooping of your upper lids. In the photo, you appear to have not just extra tissue but a true ptosis, most likely due to muscle weakness. This requires a ptosis procedure, such as a levator advancement or a Muellerectomy, to repair and, in my opinion, is best performed by an oculoplastic surgeon.
Juvederm: the new lower lid lift?
The fastest growing procedure in my office is filler for the hollow under the bags under the eyes. As we age the fat pad under the cheek shrinks and sinks, leaving a flat cheek and a hollow groove know as a tear trough (imagine tears running down your cheek in a depression). If there is any puffiness under the eye it can begin to look like the dreaded "bags"!. In the old days (a few years ago), your option was to cut out the bags leaving more hollowing over flat cheeks.
With the arrival of fillers like Juvederm and Restylane we can add some of the lost volume back in a safe way. For many people this technique is highly successful and surgery is avoided. Only very experienced injectors with expertise in the eye area should be considered. I am not infrequently called upon to correct problems caused by unqualified practitioners.
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Fillers and lower lids
Fillers in the lower lid trough are good, howver, they may make the bags appear a bit more swollen due to water retention. If you have fatty bags the best way to treat them is by excising them.
Lower eyelid bags
some patients respond nicely to fat repositioning, others respond to fat removal and others do well with fillers in the tear trough. you would need an evaluation in person.
Juvederm Help My Dark and Puffy "Bags"
Thanks for the frontal photo. I really would feel better to see you in an in person evaluation. But since you are asking over the internet, I would recommend Selphyl regenerating fillers to the cheek and tear trough, Botox to the upper lateral orbital to elevate the eyebrow laterally.
Eye Rejuvenation Recommendations - please meet with qualified facial plastic surgeon
Dear Alan - I would recommend an in-person consultation with a qualified surgeon. As you mention the photo minimizes your major concerns. Filler is an option but lower blepharoplasty without or with fat transfer should also be considered. Neurotoxin would likely provide lateral brow elevation which is something you might not want. However, an in-person evaluation and discussion of your desires would be much more helpful for you and your physician.
Stephen Weber MD, FACS