Is 31 Too Young to Get Under Eye Bag Surgery?

Question

I've had under eye bags since I can remember. I've tried everything under the sun to fix the problem, but I realize I might need to get surgery to get rid of them. I used to have them really bad on Monday mornings (probably from drinking over the weekend) but would decrease as the week progressed. I now constantly have them and I wear glasses (non-prescription) just to hide them. Can someone provide a price range for the surgery?

Lawrence Kass, MD · Answer

I think you would be an excellent candidate for transconjunctival lower lid surgery.  Use of an filler to the under eye hollows might also be considered as a nonsurgical option.

Scott Trimas, MD · Answer

There are no age specific criteria for lower eyelid surgery. The nice thing about being younger when you have the excess fat of the lower eyelids removed is that typically no other treatment for that area is necessary. The procedure can easily be done by making a small incision behind the eyelid, called a transconjunctival approach, and directly removing the fat bags with no visible scarring. I cannot speak for the price in your area but in our area it runs about 2300 for the procedure and about another 1000 for the facility and anesthesia. I hope this information helps.

Vincent N. Zubowicz, MD · Answer

Some individuals have puffy eyelids as a family trait.  If they don't like the appearance, it can be addressed with eyelid surgery.  It's fairly straighforward surgery with predictably good results.

Andrew P. Trussler, MD · Answer

Lower eyelid bags can be congenital and worsen at a young age. It is not uncommon for women in their 30s with such a problem to have it corrected. Unfortunately, most plastic surgeons are recommending fillers in the area which are temporary and can make the ultimate fix more difficult. From an anatomic perspective, you have weakness in your lower eyelid and drooping of your cheek which can accentuate the skin and fat of the eyelid. For your complaint, I would recommed a lower eyelid blepharoplasty with fat repositioning and muscle tightening, as well as skin removal and eyelid tightening. You may also benfit from a midface lift or cheek lift whic can be performed through the lower eyelid as well. Costs of these porcedures can vary, but plan on taking a couple of weeks off to recover.

	Thanks

	Dr. Trussler

Jason Hess, MD · Answer

Plastic surgery is more physiologic than chronologic. At times, young women complain of naturally droopy breasts, or other issues that would seem to only affect older women. Based on the photo provided, it would appear that you could benefit from a lower blepharoplasty. This may involve skin excision and repositioning of fat. It is now customary to preserve and reposition fat rather than to excise it. Removal of fat from this region can provide a hollow aged look. There are no effective non surgical means to correct this other than laser skin tightening. In my opinion, you would be a better candidate for surgery than for laser. A laser would leave you red for a long period and would probably under-correct the problem. Price range depends, frankly, upon zip code and surgeon experience. Check your doctors license and make sure he or she is board certified. A price may vary from $2500 to $7000 depending on your doctor. You should seek a fair price, probably somewhere in the middle of these figures. But, most of all, find someone competent in this procedure as complications are difficult to correct. This is generally considered a challenging procedure.

Houtan Chaboki, MD · Answer

Hi Sylmar in Sylmar, CA,

	Generally, there are a few options to improve the appearance of the lower eyelids, eye bags, or dark circles. First option includes basic skin care, tretinoin, and/or chemical peels. This nonsurgical method helps improve the skin quality, reduce pigmentary changes, and improves overall appearance of the lower eyelid & cheek areas.

	Second more advanced option is an injectable filler or fat to plump up the area. Fillers are made of material that is slowly removed over time. Facial fillers treatment is performed in the office vial local anesthesia.

	The last option, and also the most aggressive, is eyelid plastic surgery. Cosmetic surgery of the lower eyelid may remove or reposition fat in the eye bag area, and possible remove some sagging skin. Plastic surgeons typically don't recommend cosmetic eyelid surgery in young patients. However, each patient is unique and circumstances may vary. Age alone is not a determining factor if a person is a cosmetic surgery candidate.

	Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Eric M. Joseph, MD · Answer

I read your concern and reviewed your photo which is too small to evaluate your lower eyelids. In my practice, I prefer a non-surgical approach for most of my patients with lower eyelid bags. The appearance and prominence of these fat-bags is usually due to a visible lower eyelid groove that decreases the smooth transition from the lid-bag to the cheek. A well-performed Injectable Filler treatment to the groove beneath the bag is a better option than surgery in my practice. I prefer Silikon-1000, an off-label filler, for permanent results.

	Removing lower eyelid fat may lead to a hollow, operated appearance that is difficult to correct. I've attached a link demonstrating this effect in one of my patients.

	All the best from NJ.

Robert L. Kraft, MD, FACS · Answer

Aging happens differently in different people and some individuals have family history of lower lid bags. If you are one of them, then certainly treatment could take place at an earlier age than for most patients. I would first recommend Restylane to assess whether it can produce a reasonable improvement with which you might be satisfied and, if you desired a more significant and lasting treatment, lower lid blepharoplasty could always be undertaken.

David C. Mabrie, MD · Answer

95% of the patients I see with bags and dark circles under their eyes have them because of an indentation, or small valley at the transition from the eye socket to the rest of the face.

	In my practice we use fillers to smooth this transition area and to augment the cheeks.  We have had great success with this.

	While 8 years ago, lower lid Blepharoplasty was the best treatment available, today, most people are best treated with fillers.

	Good luck in your search for information.

Mark Preston, MD · Answer

I do not have a specific age restriction for doing lower eyelid surgery. The need for surgical correction is not based upon your chronological age, but on the condition of your eyelids. You may be one of those who was just born to have droopy lower lids. They can be fixed at age 31 or 61.

Is 31 Too Young to Get Under Eye Bag Surgery?

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