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Female speaker: What can I do to get rid of my eye bags? I'm 29 and for as long as I can remember, I've had bags under my eyes. I've always avoided the filler route because I've been told it will make it worse. Is bleph my only option? I also have hyperpigmentation here, which makes it look even worse. I'd really like to improve the look of my under eyes and would love to know what my options are. I think this is hereditary.

Dr. Amiya Prasad: Thank you for your question. At the age of 29, you described having always had bags under your eyes and that you stated that you avoided fillers and you wanna know whether or not blepharoplasty is your most practical option. I have to congratulate you on making that assessment. For years, once there was an introduction of particularly the hyaluronic acid fillers such as Restylane and Juvederm. It became almost the Holy Grail for non-surgeons to try to help their patients with bags under their eyes by trying to fill in hollows and to "camouflage" the appearance of bags.

Now we do this type of procedure in our practice but there really is a limited type of volume that can be placed that can be effective. This material is very. What we see a lot in our practices, patients coming to actually have the hyaluronic acid done elsewhere, removed by an enzyme called hyaluronidase. That's because once you get puffiness beyond a certain level, it just doesn't work.

Let's discuss a little bit about why you have the puffiness. First, the anatomy. The anatomy is basically something called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that's normally around your eyes pushes forward and creates a bulge that makes the eyes look puffy and makes you always look tired. When you have a history where you always recall having bags under the eyes, it's most likely a genetic trait. In my practice, I've operated on several generations within the same family with exactly this type of situation.

In a younger person like yourself that there's no excess skin, which is typically the case, we do a procedure called the transconjunctival blepharoplasty. Transconjunctival blepharoplasty is a procedure where we approach the lower eyelid from the inside and thereby avoid an external scar. This way, we are able to reduce, reposition and address the herniated fat. The fat that's pushed forward in a way so that we can make the eyes appear as if you never had bags under your eyes. It's a very natural look.

[Inaudible] aside, one of the most common phrases we hear from our patients who were thinking about doing this for a long time, they'll often say after it was done, "If I knew it was this easy, I would have done it sooner." And part of that is of course the hesitancy about doing surgery at all, but also in our practice, we do these procedures so much, we do it under local anesthesia with light IV sedation. We've made this process very easy for people even younger people to have done with minimal interruption or disruption in their lives.

That's what I would recommend for you in the absence of a physical examination by just looking at your photos.

In terms of skin quality and hyperpigmentation, depending on the type of issue that is responsible for this, sometimes pigmentation is due to genetics just like a regular skin color. Other times pigmentation may be due to environmental factors such as sun exposure or people who work outside or has spent a lot of time with incidental sun exposure.

Routinely to help people with dark circles or hyperpigmentation, we do an injection of something called platelet-rich plasma. Platelet-rich plasma is something that we developed from your own blood. What we do is we draw your blood like a regular lab test and then we spin it, so that we can concentrate the platelets, the serum and essentially the growth factors and healing factors necessary for wound healing. When this is injected under the skin of the eyes, we will actually see significant improvement in skin quality. In your situation as a younger person, we found this to be very, very helpful.

In some cases, we'll actually, from the outside, use a laser to tighten the skin and to resurface the skin. There are complimentary procedures that help maximize the overall appearance of the lower eyelids. At this point, my recommendation is to meet with qualified, experienced cosmetic surgeons to discuss your options as to how to address this area. I would suggest making general anesthesia something you avoid if you can. Once you do that, I think you'll be very pleased with the ultimate result of not having the bags under your eyes anymore.

I hope that was helpful. I wish you the best of luck. Thank you for your question.

Best Procedure For Under Eye Bags: “If I Knew It Was This Easy, I Would Have Done It Sooner!”

Looking to fix the appearance of your under eye bags? Dr. Amiya Prasad reveals a common procedure you should probably avoid and which fast-healing surgery has received rave reviews.

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