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There appears to be a significant bulge of lower eyelid fat prolapsing forward along with a depression at the eyelid-cheek junction. Therefore I would probably recommend a cosmetic lower eyelid blepharoplasty performed through the inside of the lower eyelid(called a transconjunctival blepharoplasty) followed in a few weeks after surgery by lower eyelid hyaluronic acid gel fillers like Belotero or Restylane to fill any depressions that may remain at the eyelid -cheek junction.
Based on your pictures, in my opinion, lower eyelid surgery, arcus marginalis release and fat redistribution would give the best aesthetic, long lasting, predictable and consistent outcome. This will correct both the bagginess and hollowness of the lid/cheek junction.
A transconjuctival lower eyelid blepharoplasty with release of the ligaments and preservation/redraping of the fat compartments over the bony structure is more indicative in your case. However hyaluronic acid filler injections are a conservative alternative that can improve the contour and camouflage to a certain extent the fat prolapse. I would recommend a monophasic filler like Belotero as it has better distribution within the soft tissues. Even if you opt for a surgical approach, fillers might be still necessary to further refine the eyelid-check junction contour.
often can produce a nice temporary cosmetic improvement in some patients, but
not all. They certainly do not achieve what a well performed blepharoplasty
help improve the cosmetic appearance but you will get only a temporary and
limited improvement with them. A better and long standing correction would be
achieved with a blepharoplasty of the lower lids: Conservatively removing any
excess loose skin that may be present, contouring the bulging fat pads, which
are generally inherited, unrelated to weight, and tend to protrude more with
time, and smoothing the tear troughs with micro-fat grafts or fat
mind that following advice from a surgeon on this or any other website who
proposes to tell you exactly what to do based on two dimensional photos without
examining you, physically feeling your tissue, assessing your desired outcome,
taking a full medical history and discussing the pros and cons of each
operative procedure would not be in your best surgery. I would suggest that you
find a surgeon certified by the American Board of American Plastic Surgery and
one who is ideally a member of The American Society for Aesthetic Plastic Surgery
(ASAPS) that you trust and are comfortable with. You should discuss your
concerns with that surgeon in person.
Singer, M.D., FACS
Your photos appear to show fat causing the puffiness under your eyes. If this is the case, it could be improved surgically, with lower blepharoplasty or a filler could be injected under the bags to help camouflage them. The result from surgery would be longer lasting and deal with the root of the issue whereas the filler would be temporary and improve the appearance by filling the depressions under the bags. If you went with a filler, I would recommend one of the hyaluronic acid products.
You look like you have the classic lower eyelid pillows. Classically with was addressed with transconjunctival lower blepharoplasty. More recently this has evolved into transconjunctival lower eyelid arcus marginalia release surgery where the lower eyelid fat is preserved and transferred as a living pedicle into the lower eyelid to fill the tear trough hollow. The physical exam is very important because what looks like lower eyelid herniated fat may be the bony orbital rim, in which case you will be very disappointed with surgery. Now having said that, if your skin quality is good, fillers are a very reasonable alternative to lower eyelid surgery. This also reduced the pressure to have a surgery just months before your wedding. Just remember that the filler service is a bit fussy so you need to find the right injector and get this done now! With the wedding so close, I recommend exploring the filler.