27 Year Old Female W. Eye Bags. Is Surgery Avoidable? (Photos)

I have eye bags. I sleep only 4-5 hours a night, but not sure if that is contributing to my eye bags. I also have under eye wrinkles and crow's feet when I smile :( Are there any effective non surgical interventions?

Doctor Answers 15

Non-surgical lower eyelid treatements

I would agree that life-style contributes to a tired lower eyelid appearance, but you clearly have anatomic issues there as well. Wouldn't hurt to change your lifestyle (we should all try to be more healthy), but I think you will still benefit from a filler, such as Restylane as mentioned on other posts, and possibly a neuromodulator (e.g. Botox) for the wrinkles.

Springfield Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Eye bags

I recommend more sleep (don't we all need it) and an awareness of lifestyle changes to see if this enhances the appearance of the "tired" lower eyelid bags. Fillers such as Resylane or Belotero can address hollows, while botox can target fine lines and prominent folds from muscles of facial expression. Excellent skin care and sunblock is also beneficial. I suggest a consultation from a local eyelid specialist for an individualized treatment plan. Kind regards.

Malena Amato, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

Fine lines and wrinkles can be treated non-surgically. Eye bags are an internal problem so only surgery can treat them.

Based on the photos that you sent, you appear to have something called lower eyelid fat prolapse. That means that the fat pockets that are normally around your eyes have pushed forward. Many of my patients look for under eye creams and solutions that are guaranteed to get rid of bags and they don’t work because they only work topically when the problem is internal. Basically, there’s no non-surgical way to get rid of bags under the eyes.

In our practice, we commonly use a minimally non-surgical approach to camouflage the bags such as the use of Restylane or another hyaluronic acid filler adjacent to the bag at the tear trough area. But my recommendation for someone who has lower eyelid fat prolapse is to do a surgical procedure called called lower eyelid blepharoplasty. If there’s no excess skin eyelid skin, I do something called a transconjunctival blepharoplasty. In this procedure, the fat pockets are taken from inside the eyelid. This is done in our own facility with local anesthesia and IV sedation.

Lines and wrinkles are a lifelong management issue because as long as you’re alive, moving and smiling, you’re going to have wrinkles but you don’t need surgery to solve them. There are two types of wrinkles: one is dynamic wrinkles (crow’s feet), and the other is called static lines which form when you smile and become deeper and are present even when you don’t smile. In our practice, we use Dysport and Botox to treat the crow’s feet areas and they also help reduce the appearance and permanence of these lines.

For the fine lines under the eyes or the crisscross lines, we like to do a couple of things. The most conservative thing to start with is retinoids whether using Retin-A or any other product that is by prescription. Some of the over-the-counter products can have some pro-retinol or some metabolites that do help the lines. In our own practice, we have our own retinol formula which help cell turnover to help improve the lines. Unfortunately, retinoids have a tendency to dry the skin and some people are sensitive to it. We can also treat fine lines with lasers, radio frequency such as Pelleve, and platelet-rich plasma which is drawn from your own blood and uses your own growth factors to stimulate collagen.

I think it’s probably best for you to do some doctor shopping and get to know a doctor that resonates with your personality and understands what your objectives are. Once you do, come up with a plan that works for you. I hope that was helpful to you, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 72 reviews

Non-surgical eyelid procedures for bags and wrinkles

Non-surgical options can provide an improvement in many patients with signs of lower lid aging.  You may be a candidate for hyaluronic acid fillers (ie Restylane or Juvederm) to the lower lid/cheek area to help improve your lower lid bags.  This can last up to 1-2 years in many patients.  Botox can certainly help with your crows feet as well.  Both of these can be done at the same time or at different office visits.   

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 104 reviews

Correction of lower eyelid bags without surgery

Many young women complain about lower eyelid bags.  From your photos, it appears that you may have shallow cheek bones, which can contribute to the early appearance of eyelid bags.  Correction of the these with Juvederm or Restylane works very well and can last up to a year.  A more invasive, although permanent, solution is to inject your own fat into this area.

Either option will help "erase" the bags under your eyes...but getting a good night's sleep and staying properly hydrated will help some, too.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 11 reviews

Surgery for Puffy Eyelids in a Young Female

Lower eyelid fullness (puffiness or "bags") develop from multiple factors- genetic (look at pictures of your parents and grandparents); sleep habits; allergies; bodily fluid shifts/salt retention; etc.  At your age with your sleeping habits, surgery can be avoidable- try adding an extra 1-2 hours' sleep (ideally 2-3 more) at first.  Then try an old Hollywood trick- Preparation H cream at night.  At worst, that won't work and you'll lose $10, but you'll gain some sleep.  After that, fillers such as Restylane or Juvederm do a great job, and you avoid the surgical risks.  Surgery should be your last option- be sure to consult with a board certified oculoplastic/facial plastic/ or general plastic surgeon.  For the wrinkles and crows' feet, Botox (or Dysport or Xeomin) injections are hands-down the best option.

Christopher R. Hove, MD
Paoli Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Non-surgical eyebag treatment

Mild to moderate lower eyelid bags may be treated by injection of fat dissolving agents as well as filling below the eyelids with injectables such as Belotero, Restylane, Radiesse and Artefil.

Please consult in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions. Cheers

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Eye bags at 27

Thank you for your question about the bags under your eyes.

  • These are inherited. Lack of sleep may worsen them,
  • For the eye wrinkles/crow's feet - Botox and avoid the sun,
  • Although fillers may soften the lower lid bulge, it is not cost effective at your age. In 2 years you will spend as much on fillers as on surgery,
  • Surgery is a transconjunctival blepharoplasty, outpatient and invisible incision. Hope this helps. Best wishes!

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Surgery for eye bags

It looks like you would be a good candidate for Restylane injections into the lower eyelid. There is hollowing your upper cheeks as well and I would add some additional filler into this area to optimize your results. I would not recommend surgery to remove fat, as I suspect this will make your face appear overly thin and gaunt.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 167 reviews

Under eyelid bags

The non surgical options includes temporary fillers such as Restylane or Belotero or more permanent such as fat injections. See an experianced injector for injections in this area.

Good luck

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