Options for under eye bags caused by muscle hypertrophy?

Hi, This has been a problem since I was a little girl, now I'm 40 and want to improve the appearance of my under eye bags, whether it is with surgery or fillers.

I look tired all the time and my bags just keep getting bigger as I age. I went to my consultation for blepharoplasty (Eyelid Surgery).

She told me there's nothing that can be done, because it's all muscle and not fat. Could I have hypertrophy? What can I do? I can't stand to look at myself or have others look at me. If there is surgery for this, what is it called?

Options for under eye bags caused by muscle hypertrophy?
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16 answers to “Options for under eye bags caused by...”

A: Lower eyelid bags due to muscle hypertrophy

William Portuese, MD

According to the picture that was presented, yes, indeed, there is a slight hypertrophy of the muscle on the lower lids. It is impossible to go in and remove this because it will leave you with a weakened and paralyzed lower lid and is not advisable to have anything done about it. There does not appear to be... more

A: Your eyes are not the problem

Parham Ganchi, MD

In the photo, your eyes look great and I wouldn't do anything based on this photo. I would like to see a photo of your face when you are NOT smiling.  Most likely, you have volume loss in your cheeks and under you eyes. This can make you look tired and gaunt even though you don't have any bags under... more

A: Lower Lid Muscle Hypertrophy

Christopher L. Hess, MD

I think we all can appreciate the issue that you're having.  However, it's not that the muscle is changing but the aging process is changing your lower lid/cheek junction.  As we age the deep tissues of the face descend.  This creates worsening of the nasolabial folds as well as a more... more

A: botox and filler.

Richard Gentile, MD

Hi Shellee: would consider a little filler under your rim and some botox to decreasing the orbicularis contraction that is causing you to have a more significant orbital rim depression.  Surgery a bit drastic for you slight problem.  I prefer to use Radiesse under the muscle and just below the rim.

A: lower eyelid shape

Trevor M. Born, MD

Dear Shellee, what you are describing and whag can be seen in the photo may not be the same. Muscle hypertrophy of the lower wywlid can be treated with a little Botox and if there is an underlying hollow- this can be corrected with micro fat grafting or placing Restylane on the deep layer in the hollow on the... more

A: You look wonderful, I would never make an incision on your eyelids

Brooke R. Seckel, MD

You are very pretty with lovely eyes and a young-looking face. I definately would not make an incision on your eyelid and try to reduce the orbicularis muscle--you would loose the natural beautiful look of your eyes. As you get older, if you do consider any procedure at least think about an open fat graft (NOT... more

A: Options for under eye bags caused by muscle hypertrophy?

Ricardo Rodriguez, MD

 Your doctor was correct in identifying this as a muscle problem. Some have suggested Botox, and others excision of muscle. I would try the Botox first to see if you like the effect. If you do like it and decide to go ahead with a blepharoplasty, make sure the surgeon excises ONLY muscle, and not skin.... more

A: Muscle volume can be reduced

Robert M. Jensen, MD

If your problem is due to muscle hypertrophy, then it can be corrected very nicely with lower Blepharoplasty surgery.  The technique involves debulking the muscle mass along the width of the lower lid.  This gives a very natural and long lasting result.  I would seek a second opinion from a... more

A: Lower eyelid muscle

Steven Wallach, MD

The area of concern is due to the muscle contracting along the lower lid. I would not use Botox along this area, because it may lead to an ectropion( drooping lower lid). You are an attractive woman with normal anatomy..leave it alone.

A: Eye "Bag" Options When Caused by Muscle Hypertrophy

Michael A. Persky, MD

Hi Shellee, Unfortunately we are our own worst critics. You have a beautiful face, smile, and believe it or not ,eyes. Sorry that you feel uncomfortable with others looking at you, but as a facial cosmetic surgeon, I will give you my opinion...actually I already have above. If you were my patient I would treat... more

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