30 yr old with asymmetrical under eye bags (Photo)

Question

I've had uneven under eye bag/lines since I was young. I've noticed them to be more pronounced in my late twenties. I have always been self conscious of how they look when I smile and would like to improve the appearance of them permanently.

Alan Gonzalez, MD, FACS · Answer

Hello @littletwinklestar123, thank you for your question. It is important to remember that we aren't completely equal on both sides; there are always some differences that may or may not be noticeable. Uneven folds or asymmetry under the eyes can be a common cosmetic concern, especially in individuals from East Asia where there is a greater prevalence of a shallow orbit, a low-lying bony structure beneath the eyes. It is wise to keep this in mind when setting expectations.

Here are some options that may help address uneven folds under the eyes:

Dermal fillers: Hyaluronic acid-based dermal fillers can be used to add volume and restore symmetry to the under-eye area. The procedure involves injecting small amounts of filler into the area to create a more even appearance. Results can last anywhere from 6-12 months, depending on the product used.

Lower eyelid surgery: In some cases, lower eyelid surgery, also known as lower blepharoplasty, may be recommended to address uneven folds under the eyes. The surgery can remove excess skin, fat, and muscle, and tighten the skin in the under-eye area to create a more even appearance. Recovery can take up to several weeks.

Radiofrequency microneedling: Radiofrequency microneedling is a non-surgical procedure that can be used to tighten and rejuvenate the skin in the under-eye area. The procedure uses tiny needles to create micro-injuries in the skin, which stimulates collagen production and helps to tighten and firm the skin. Results can be seen within a few weeks, and several treatments may be required for optimal results.

It is important to consult with a qualified and experienced aesthetic professional or plastic surgeon to determine the best treatment option for your specific concerns and goals. Best wishes!

Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

C. Blake Perry, MD · Answer

You could be a candidate for lower lid blepharoplasty. This surgery utilizes an incision from behind the eyelid to reposition the fat into the tear trough. Best to see an eyelid expert.

Zoran Potparic, MD · Answer

It appears that your asymmetry is more visible than in average person. We all have it. Augmentation of the smaller cheek with fat grafts and lower, transconjuctival blepahroplasty, would be options to consider. Hope this helps.

Whitney Pafford, MD · Answer

Whenever I'm consulting with a new patient I'll often remind them that the two sides of the face are sisters not twins. It's not uncommon for the anatomy on one side of the face to be slightly different than the other side. Based off the two pictures shown and the fact you've had this since you were young, I'd recommend a lower lid blepharoplasty with fat grafting. Both sides have shadowing from prolapse of the fat pads around the eyes. The soft tissue of the cheek on the left side is not as full as it is on the right side which makes the fat prolapse on this side more visible. Filler may improve this symmetry, but filler around the eyes can encapsulate and cause swelling. I usually don't recommend filler in this area if you are considering surgery. I'd recommend making an appointment with a local Facial Plastic Surgeon, Oculoplastic Surgeon, or Plastic Surgeon in your area who specializes in this procedure.

Jordan R. Conger, MD · Answer

Good morning and happy holidays!
I can understand how this can be a frustrating situation. There are different options for you in terms of improving symmetry and reducing the appearance of the puffiness in the lower eyelids. As you want a permanent solution, a surgical option may give you the longest lasting results. Your concerns may be addressed by performing a transconjunctival (scarless) lower eyelid blepharoplasty to excise or reposition the lower eyelid fat. There are other non surgical options including filler, but these may not be as long lasting and also carry other complications. 
I hope this helps!

Mats Hagstrom, MD (license on probation) · Answer

The human face is asymmetrical on all people. No one has symmetrical face. The human membrane is accustomed to seeing asymmetry as normal.During embryological development, the two sides of the face develop independently from each other, and eventually fuse in the midline.
Your face looks very normal, and I don’t see the indication for intervention.
Best,
Matt hagstrom, MD

30 yr old with asymmetrical under eye bags (Photo)

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