Bags Under Eyes (Age 48) - Treatment Options?

I Am 48 Yrs Old and I Have Bags Under my Eyes What Can I Do to Fix That?

Doctor Answers 9

Treatment of eyelid bags

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There are a number or different procedures to treat lower eyelid bags, the most effective involves a surgical procedure, blepharoplasty or eyelid surgery.  In this procedure the excess/stretched  skin and muscle is tailored and resuspended.  The puffy eyelid fat pads may be tailored, repositoned or grafted depending on you particular situation.  If the fat bags extend down over the cheek - refferred to as festooning - a further procedure such as a mid face or cheek lift may be necessary.  Other treatments such as fillers or fat grafts could also be considered depending on your individual situation.  You should consult a board certified plastic surgeon to discuss which option would be in your best interest.

San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Multiple treatments for under eye Bags

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There are multiples causes of eye bags. While blepharoplasty is probably the longest lasting and most 'complete' technique, there are many patients who do not want the risks and complications and higher costs associated with surgery. In some patients particularly if the bags are secondary to a sight to moderate excess of skin or loose skin then the Pixel Laser or fractionated Co2 laser can offer significant improvement. It too will have downtime with it . The length of the downtime will be dependent on the aggressiveness of the treatment. An ALTERNATIVE technique with NO DOWN TIME - unlike the two previous techniques- is the injection of a filler to mask the lower eyelid bags. While this technique is not permanent I have seen it last for several years depending how much trauma there is in the area. I have described this technique in several lay magazines. Patients like the immediate improvement with minimal risk ( mostly slight bruising).patients often don't want to have to tell anyone that they are undergoing a procedure. The filler technique lends itself to this. A doctor who frequently performs this procedure can tell you if you are a candidate. Of surgery

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Treatment for bags under the eyelids

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Treatment would be directed by an examination of your lower eyelids - photos would also be helpful.  An option in some individuals is filler to help "mask" the bags by adding volume.  The surgical treatment if you are not a candidate for filler would be lower lid blepharoplasty - most surgeons perform this through a transconjunctival (inside of the lid) approach to remove fat.  If your lid is lax or loose, then a tightening procedure and skin excision if necessary, can be performed concurrently.

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon

Eye Bags, Circles, and Demarcations

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There are many causes of eye bags. Some are shadow issues, some are discoloration issues.  Most people have a multifactorial problem meaning they have more than one problem causing this demarcation. Below is a list of common causes and my treatment protocol. The treatment is individualized to your specific issues so the best thing is to see a surgeon in your area that does a lot of lid surgery. 

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat transpositioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and/or fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Treatment of lower eyelid bags

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The treatment of lower eyelid bags is very individualized, and largely dependent on your physical examination.  The problem can certainly be corrected with a blepharoplasty/eyelid surgery.  Some people have bags due to excess skin, and others have either excess fat, or fat herniation/bulging.  Most people have a combination of problems.  Depending on your individual situation, the bags can be corrected by skin and or fat excision/repositioning.   

B. Aviva Preminger, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

Do not Remove Fat From the Lower Eyelids. If Done You Will look Skeletal.

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Do not remove the fat from lower eye lids.  Period.  Lower eyelid fat is not excess fat it is herniated fat.  I equate removing it about as logical as cutting out a piece of your intestine in an abdominal hernia.  Look in the mirror.  Look at others.   97 % of humans are fat deficient.  We are hollowed eyed creatures as we age and it only gets worse.  Aging is a process thet entails loss of fat.  As  we age we look more and more like skeletons.  We are hollowed eyed.   Removing your eyelid fat makes no sense.  It makes you more hollow.  It makes you look older and worse, not better.  Now there are the few congenital fat excesses that merit the fat removal but 97% of us need our fat.  We need fat or filler added, not removed.  The proper blepharoplasty for you is a fat repositiong procedure that saves your fat, places it in a great useful position of hollowness thus correcting the hollowness.  Then muscle suspension.  In more severe cases a cheek lift or midface lift can accompany the lower lid blepharoplasty.  A canthopexy may be useful. In addition often it is necessary to add fat to  the orbital area i ncluding the lower lid,  not remove it.  Fat from under your chin works great for the fat graft. If you have no under chin or neck fat, use absomen or arm fat.  Do not ever throw away  lower eyelid fat.  When we age we show hollow skeletal eye sockets as part iof the process.  Why speed that aging process on.

Correction of eye bags

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Correcting eye bags if due primarily to an excess of visible fat can be corrected with a transconjunctival lower blepharoplasty through a small incision behind your eyelids without leaving a visible scar. Talk to your surgeons in your area about that procedure. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

"Bags" under eyes respond well to blepharoplasty

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As we age, the tissue that "holds back" the under eye fat relaxes, and the fat moves forward becoming more visible. The "extra" fat is removed with lower lid blepharoplasty, along with any extra sagging skin. This is a "minor" surgery. In some clients, a volume filler may help fill in the "trough" below the "bag" area. A Plastic surgeon experienced in fillers can evaluate your situation and make a good recommendation.

Debra Irizarry, MD
Crestone Plastic Surgeon

Bags under eyelids

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Hello eyelid patient from Santa Barbara,

Bags under the eyelids could be due to a number of things, most commonly if they are related to aging eyes, they are due to protruding eyelid fat.  Assuming it is fat that is your issue, it can usually be removed with a lower blepharoplasty.  Other causes for bags under the eyes, could be excessively loose skin and muscle of the eyelids which can also be removed with a blepharoplasty.  There are a few different ways a lower blepharoplasty can be done.  It is best to have a consultation with an experienced cosmetic surgeon to see which procedure may be best for you.  You should also be evaluated for allergies and thyroid dysfunction as these can also lead to bags under the lower eyelids.  Best of luck

Mark Ginsburg, DO
Media Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.