Options for minimizing remaining eye bags after Blepharoplasty?

I am a young-looking 55 year old. I had lower Blepharoplasty over 3 months ago to correct what I thought were eyebags, but I'm not happy with the results. I still have the eyebags, and now I have undereye wrinkles, and one of my eyes appears bigger (I know some asymmetry is normal, but it wasn't noticeable before).

After doing a lot of reading, I now realize that the "bags" are probably malar mounds or festoons. My doctor is recommending a chemical peel to minimize the "bags" rather than any surgical revision. How does a chemical peel compare with the various laser options? What are my other surgical and non-surgical options, and should I go to an ocular plastic surgeon at this point?

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13 answers to “Options for minimizing remaining eye...”

A: Experienced facial plastic surgeon or oculoplastic surgeon

By William Portuese, MD - Seattle Facial Plastic Surgeon

If the bags underneath your eyes are malar edema or festoons, this is not addressed with a blepharoplasty. Chemical peels and laser resurfacing will not minimize those bags. A mid facelift may help. If they are severe, direct excision can be performed. An oculoplastic or an experienced facial plastic... more

A: Malar bags will not improve with peels

By Steven Wallach, MD - Manhattan Plastic Surgeon

If they are true malar bags, then it is extremely unlikely that they will improve with peels. Malar bags are usualy due to poor lymphatic drainage on the cheeks. Think of them like when the feet swell. They will fluctuate in size. Some individuals can try facial fillers although they may make the bags... more

A: A chemical peel will not help malar bags

By Andrew Miller, MD - New Jersey Facial Plastic Surgeon

As we age, many changes take place around the lower eyelid. The orbital fat can bulge forward and the fat overlying the bony rim can diminish causing a groove. Also, skin and soft tissue can sag over the cheekbone area causing malar bags. These bags can be extremely difficult to remove. Standard lower... more

A: You really need a good exam first

By Jeffrey Zwiren, MD - Atlanta Plastic Surgeon

In order to determine which technique would be most beneficial for you it would be very important to understand your pre-existing anatomy. The real answer is that the appropriate procedure technique must be matched to each persons individual anatomy. It is important to understand several of the following... more

A: Different issues, different treatments for eye bags after Blepharoplasty

By Robert M. Freund, MD - New York City Plastic Surgeon

Festoons are bags of the lower eyelid that are the result of swelling or sagging of the muscles around the eye. If it is swelling it may improve over a 6 month period. Lymphatic massage can help. If the festoons are the result of sagging muscle, tightening will improve these problems somewhat. Assymetry can... more

A: Lower Blepharoplasty

By Daniel Reichner, MD - Orange County Plastic Surgeon

Sue Lower eyelid surgery (Blepharoplasty) is one of the more difficult operations. I have seen the technique of various "specialists" over the years and I don't think it matters whether your surgeon is a plastic surgeon, facial plastic surgeon, oculo plastic surgeon or cosmetic surgeon - but it... more

A: Malar bags and blepharoplasty

By Talmage J. Raine, MD - Chicago Plastic Surgeon

Your question could, of course, be better answered with a physical exam. Generally speaking, the lower lid is quite challenging and very nuanced. It never ceases to be a great challenge to even the most masterful surgeon. Both of the suggestions, laser and chemical peel, will help the wrinkled skin but may... more

A: You might need revision surgery in the future

By Stella Desyatnikova, MD - Seattle Facial Plastic Surgeon

A chemical peel in general is not the best option for treating malar bags or festoons. Unfortunately, they are notoriously difficult to treat in general. Usually, the best chance of diminishing them is with surgery - some form of an extended lower lid blepharoplasty. At this point, I think, I would talk to a... more

A: Festoons are hard to treat

By Brooke R. Seckel, MD - Boston Plastic Surgeon

Dear Sueesquisite, Festoons or malar bags, if that is the problem, are very difficult to treat. I have tried deep laser resurfacing and deep Infrared skin tightening technology and been disappointed with the results. I have had good luck wiith a lateral eye/cheek lift performed through a lateral extension of... more

A: This depends on the cause of the "bags"

By Jacob D. Steiger, MD - Palm Beach Facial Plastic Surgeon

The answer to your question depends upon the reason you have these "bags." If they are a result of left over lower eyelid fat, treatment would be directed towards that. However, sometimes after lower lid blepharoplasty, removing eyelid fat can accentuate excess skin. In these cases removing the... more

More answers to Options for minimizing remaining eye bags after Blepharoplasty?
Los Angeles - There is no simple answer to this problem
New York City - You probably need a revision with tightening of the lower...
Seattle - Lots of options-stick with your surgeon

Comments

lec
4 posts
8 Feb 2009

eye lids swollen after 4 weeks

aliu
109 posts
28 Jan 2009

Hi Sueesquisite, Unfortunately it sounds like a lower bleph was not what you needed in the first place. When evaluating the mid-face area, it is crucial to differentiate between lower eyelid and cheek appearance which includes malar bags/festoons/tear trough issues. If the appearance you don't like is b/c of cheek changes, no lower eyelid procedure will ever properly address your concerns. That being said, there are surgical and non-surgical options to address the cheek area. Non-surgical options are lasers/chemical peels/Thermage (any non-invasive skin tightening procedure). These typically work the best for smaller festoons. In my experience, laser seems to work better than the others. If the appearance is secondary to a lack of volume in the junction between cheek and lower eyelid, then dermal fillers (Restylane, Juvederm, Radiesse, fat, etc...) can all be used to supplement the lost volume. Surgical options include cheek lifting, fat transposition/grafting/, cheek implants. It is important to differentiate between loss of volume versus vertical descent of sufficient voulme. That will help determine whether the procedure performed should be one of vertical repositioning or re-volumizing or both. As a cosmetic surgeon with oculoplastic fellowship training I feel very comfortable taking care of this area but I feel that any oculoplastic surgeon/plastic surgeon/facial plastic surgeon/cosmetic surgeon with specialized interest in the mid-face should be able to help you figure out what best procedure to address your concerns. Best of luck!

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