I am a 27 year old female and have had puffy eyes for as long as I can remember. I get bad allergies in the spring which I believe to be a lot of the cause. However, I have bags all year long (just worse with allergies). I recently visited a dermatologist who said she did not believe I had "fatty bulges" but more fluid retention and suggested Thermage. I am desperately looking for a procedure other than invasive surgery and I feel that the bags make me look unhappy and old. Is there any proof that Thermage will work for this? Are there any other treatments that will last a long time and be effective?
Will Eyes by Thermage Help Reduce Puffy, Baggy Eyes?
Doctor Answers (12)
Treat the Underlying Condition First
Severe allergies, thyroid conditions and a host of other medical conditions can cause excessive swelling around the eyes. This is significant because it means that removal of periorbital fat will not be of benefit. You should first be placed on an aggressive allergy medication and avoidance therapy for several months and not how much improvement can be achieved. Once you have been treated for several months see how much improvement you have achieved. I personally do not advocate Thermage for many reasons and would not recommend its use around the eyes.
Thermage for eyelids
Thermage works well for some patients on the loose skin of the upper eyelid but bags of swelling fluid retention on the lower eyelids may not respond well.
Thermage will not correct eye bags
Eye bags, puffy eyes, bags under eyes, and dark circles under the eyes are most often caused by a condition called orbital fatty herniation.
If your bags are constant and not cyclical related to allergic reactions or fluid retention, then fatty orbital herniation is the most likely cause.
Thermage is a skin tightening technique using Infrared energy. It cannot be safely used on the eyelids, and if it is used, can only tighten the skin about 20% and will have NO EFFECT on eye bags (which are caused by protrusion of fat beneath the eyelid skin).
Correction requires repositioning of the protruding fat that is bulging and pushing the lower eyelid skin forward into a bag.
If you have a dark circle or indentation beneath the lower eyelid you may also have the arcus marginalis deformity, which can also be corrected with blepharoplasty.
The most modern techniques involve a transconjunctival approach through the inside pink portion of the lower eyelid. This avoids a visible external incision which can change the shape of your lower eyelid.
Today, we also reposition the fat instead of removing the fat. Fat removal can create a hollow appearance. By repositioning the fat on the cheek bone, the eye bag is removed and the eye and upper cheek area looks more full and youthful.
Please see the links for before and after pictures: Set 1 and Set 2
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Treatment for baggy eyes
Once medical management has failed, consideration for a trans-conjunctival( inside the eyelids) approach for conservative removal of fatty deposits in the lower lids under a very brief general anesthetic. Anticipate approximately 10 days bruising and swelling after the procedure. For many examples, please see the link below to our surgical blepharoplasty photo gallery
Treatment of the lower eyelids
The number one choice for excessive fullness of the lower eyes is a procedure known as a lower eyelid blepharoplasty. Thermage works well, but is a temporary fix. Raffy Karamanoukian Los Angeles
I would not think that you would get any reliable result with Thermage of the lower eyelids. You may want to consider Exilis.
Thermage is used to tight loose skin. As we age skin does tend to loose its elasticity. As the skin drops so does the fatty pockets under the eyes, which can cause the appearance of the dark circles. Sometimes even create some of the bags. Thermage is not the best recourse for the under eye bags. Even though it can assist in the tightening of the skin it will not take away the bags under the. Seek consultation of a well experienced Physician, let him/her see your concerns go over the causes as well as go over the best options for your areas of concern.
Thermage- Lower eyelids
Thermage is a skin tightening device- and will have a response on the lower eyelids- but only to the extent that your issue is skin laxity. Much of the 'puffiness' seen in your lower lids is generally due to fat and fluid. The upper eyelid results with Thermage are very impressive because this is mostly a skin laxity issue.
Thermage for puffy under eye bags
I would not recommend Thermage for the condition that you are describing. (Bags under the eyes).
Eyes by Thermage treatment is indicated for mild or moderate loosening of eyelid skin.
If the bags are not too prominent, you may benefit from Traditional Laser Resurfacing or Fractionated Laser Resurfacing.
If the condition is severe, you would have to consult an oculoplastic surgeon who will explain to you the latest advances in the treatment of this common and annoying condition.
Always make sure that you are being treated by an experienced, Board Certified Dermatologist or Plastioc Surgeon.
Thermage for Eyes
Our experience with Thermage for eyes has been overall excellent, particularly with tightening loose upper eyelids. About 90% of patients treated will respond with tighter upper eyelid skin. Puffy bags under the lower eyelids do not respond as well, although can be reduced. Fractional lasers like Lumenis ActiveFX can also be used for the eyes leading to tightening of loose skin.