Will I Likely Get a Good Result from Eye Bag Surgery?

asked 3 years ago by violetmom in NY
Latest answer by Rafael C. Cabrera, MD
Question viewed 6,212 times
Tags: eye bags, puffy eyes

Hello, I have terrible eye bags that are hereditary and are getting worse over time. In photos, you can hardly see my eyes. But I don't think the bags are the result of fat pads, at least not entirely. When I am not smiling, the bags are barely noticeable. It's only when I smile that they look horrible, and I think it's a matter of excess skin that bunches up. I don't know how much you can tell from a photo, but here's one that shows what I mean. I'm a bit worried about the horror stories about people who get hollowed under-eyes or rounding of the bottom eyelid, and I'm wondering if there are particular types of people who surgery works better on than others. Thanks for any advice.

7 answers to Will I Likely Get a Good Result from Eye Bag Surgery?

Lower eyelid fat herniations vs muscle roll

When eye bags are present when the patient is not smiling or squinting, and disappear when they squint/smile, these bags are usually due to fat herniations. In that case, fat reduction procedures such as transconjunctival blepharoplasty or fat repositioning blepharoplasties can help. Eye bags that are absent in repose but occur during animation indicate a muscle roll problem often combined with hollowness below the eye. This problem is actually made much worse by removing more lower... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

You don't need surgery

If your eyes look good when you are not animating them, then you don't need any surgery. What you are seeing in your photo is excessive orbicularis oculi muscle function when you smile or squint that makes it appear as though you have bags, fullness and extra skin in the lower lid. Surgery is primarily indicated for what you see at rest such as bulging fat bags. Animation artifacts like yours are best treated with conservatively administered Botox injections by an experienced physician to... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Bunching and excess skin

I am going to take the less popular position and say yes, surgery may be the answer. speaking in general terms, if there is no fat pad herniating them removal of fat is not indicated. if there is no excess skin then no skin removal is needed, if the skin texture is good, then a peel or laser is not indicated, if you do not have an orbicularis oculi bulge, then resection of a infratarsal strip of muscle is not indicated. So, looking at this one picture and taking into account what you... more

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Non-surgical Approach for Eyelid Bags

Judging from your photo, you do not appear to have eyelid fat. The bunching of your skin with smiling appears o be due to your hyperactive muscle of the lower eyelid. Surgery is not used to treat this problem. In some patients, I have had good success with botox injections to reduce the overactivity of the muscle. If you are concerned about skin laxity of fine lines lines under the eyes, I would also recommend a chemical peel.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon

Agree with Non-Surgical Approach

Hello, You have been given excellent advice here and I would only like to add that given your description of your eyes that a non-surgical approach should be considered. Some options could include: 1. Chemical peel or laser resurfacing of the skin around the eyes 2. Botox injections to improve wrinkles and appearance of eyes 3. Fat injections to help contour the eye and cheek areas These are still procedures and do require recovery time and each has their risks as well but they are... more

Kamran Jafri, MD
New York Facial Plastic Surgeon

Blepharoplasty

Lower lid eye surgery can correct herniated lower eyelid fat, and loose skin. This can be accomplished using many different techniques. It is hard to tell from your photo. Steven Wallach, MD www.stevenwallachmd.com

Steven Wallach, MD
Manhattan Plastic Surgeon

Candidacy for Blepharoplasty: Are you a good candidate for eyelid surgery

Lower eyelid surgery is performed to correct one of two things; excessive skin or excessive fat beneath the skin. This is best visualized with the eyes at rest rather than when squinting, as in your picture. Candidacy for the procedure is based on several criteria: Redundancy of skin in the lower eyelid Quality of skin in the lower eyelid Orbital fat protruding through the skin There are specific risks associated with the surgery. Experience is particularly important in obtaining a good... more

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

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