I'm 26, is Lower Eyelift the Best Procedure for my Saggy and Puffy Eye Bags? (photo)

I've always had saggy/puffy eyebags and really dislike it, I believe it's hereditary from my father. They are always present but are more visual normally in the morning and when I begin to get tired around 7pm. Is lower eyelid surgery the best procedure or are there better alternatives? Please advise. Thanks!

Doctor Answers 3

Puffy Eye bags

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The pictures show you have hereditary herniation of the fat bags in your lower lids.  This is best treated with a transconjunctival lower blepharoplasty. This is performed under a brief anesthetic and there is only a minimal amount of pain in the post-op period.  Fillers will not make this go away 

I'm 26, is Lower Eyelift the Best Procedure for my Saggy and Puffy Eye Bags?

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 Yes, a Lower Blepharoplasty or Lower Eyelid Surgery would address the lower eyelid fat bags.  I prefer using the Transconjunctival approach with the incision on the inside of the eyelids for this procedure.  

Fat prolapse

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Thanks for posting a photo. The lightening is not idea, but I think we can get a good sense of your anatomy from it.

The main issue you have identified is the lower eyelid bulge, which most likely is due to prolapsed eye socket fat into the eyelids. This often is hereditary in nature. There may sometimes be overlying swelling in the eyelids that may only be identified by a proper exam.

In addition, you have slightly flat midface [cheek] that accentuates the bagginess of the eyelid.

If cost was no object for your, I would advice lower eyelid blepharoplasty [ conservative fat only excision] combined with fat grafting to the cheek/malar region to improve the harmony of the lower eyelid and cheek.

But if you had to pick just one, I would only perform a lower eyelid blepharoplasty.

There is not only one way to address your anatomy, however. Some may advocate just using fillers in the cheek eyelid junction to camouflage the baggy eyelid. This wouldn't be wrong, just not ideal in my opinion, as it will not be a lasting result and would need addtional treatments every 6 months to a year [maybe a little longer if you're lucky].

Its always a good idea to consult a couple different surgeons to find one that you feel comfortable with. Price shopping is okay, but choose one that you feel you develop a good rapport with. And ask for before/after questions.

Some surgeons maybe comfortable with one technique over another. So sometimes you may get differing opinions.

Good luck.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

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