What can I do to rid myself of under eye bags that I got genetically? I am only 21 (Photo)

My mother and I both have bags underneath our eyes (hers are much more noticeable). She has been struggling for years to find a solution and I want to do anything I can to prevent mine becoming that bad when I get older. What non surgical treatment would you recommend for both of us?

Doctor Answers 5

I don't see eye bags caused by fat on you or your mother. It is possible to mistake eyes that look puffy when smiling

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Thank you for your question. You submitted 2 photos: one of yourself, and your mother. You state you are dealing with under eye bags that are genetically caused, and you are looking for a non-surgical solution to prevent your under eye area from looking like your mother’s.

I can give you some guidance about issues related to under eye bags. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years, and helping people with the aesthetics around their eyes is a big part of my day-to-day practice.

When I look at the photos you submitted, I have to explain a little what you are describing as under eye bags. When someone asks me about having under eye bags, it is usually in an area above the bone structure or the rim, where the eyes look puffy with large pockets, typically referred to as lower eyelid fat prolapse. In the photos you submitted of you and your mother, I don’t see those things. What I believe you are referring to is the area right below the eyelid margin where the eyelid skin appears to bulge a little, especially when you smile is often referred to as under eye bags. The difference in this area for you and your mother is it appears to be a little more prominent and you see a few more lines in your mother.

For management of this area, it is very important to first understand the basis for this concern. If it’s when you are smiling, or even when not smiling, there is a little ridge there. That ridge represents a muscle called orbicularis oculi muscle, which is important for the support of the lower eyelid. In general, this muscle doesn’t respond well to most non-surgical options such as the injection of a neurotoxin like Botox® or Dysport® to relax the muscle slightly so the muscle doesn’t bunch. When you smile, the orbicularis oculi muscle contracts, causing a ridge to form. It is possible to put something like micro Botox® or a very small number of units of Botox® in your mother’s situation more than in yours.

There is also an opportunity to at least explore the area below the muscle called the tear trough. In the tear trough area, there may be a little contrast we are not appreciating with the photos you submitted where it may look relatively hollow compared to the area just above it, which might have a slight degree of puffiness. If the tear trough area is a relative hollow, that can be addressed with a hyaluronic acid filler such as Restylane or Juvederm to fill this area, and we often combine it with platelet-rich plasma (PRP). Platelet-rich plasma (PRP) is derived from your own blood, and is a concentration of the wound healing and growth factors necessary when you have an injury or a wound. What we do with PRP is try to improve the tissue and skin quality, and help stimulate collagen, blood supply, and overall fill this area. This solution is likely more appropriate for your mother than for yourself. I realize you are trying to do everything you can to prevent the aging process to be as significant for you, but unfortunately there isn’t always so much you can do.

It doesn’t mean there are things you can’t do, but they are not limited procedures. What I am referring to is healthy lifestyle, avoiding excess sun exposure, eating a good diet, getting enough sleep, and minimizing stressors. Otherwise in the genetics of aging, there is an opportunity, maybe when you are a little older, to do things such as platelet-rich plasma(PRP) and fillers to try to minimize some of the signs of aging. However, I think it’s a little early for you to do anything that is more invasive based on the photo you submitted.

There is a level of dimensionality not being appreciated with a photo alone, so it is always valuable and beneficial to meet with a doctor who can guide you and your mother about options. It is not unusual in my practice to take care of people in several generations because of this genetic tendency for these types of issues, but at the same time, it is also the role of  your physician to guide you when to do something, what to do, and what not to do. Meet with doctors who you feel comfortable with, learn about your options, understand the distinction, the anatomic issues, the strategies, and then figure out what is worth pursuing and what is worth deferring until later. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Thank you for your question. Non-surgical treatments include one of a few different fillers. Please keep in mind that non-surgical treatments are temporary and can allow you to test drive an improved appearance. I suggest that you consult with a board certified facial plastic surgeon. Best wishes,

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Laser, fillers, microneedling/PRP will give improvement without surgery. Lower blepharoplasty could be a permanent solution. Please see an expert. Best, Dr. Emer

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Under Eye Bag Treatment in a 21 yo

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In reviewing your pictures, you are a beautiful young lady.  You appear to have a depression in the transition point from your eyes into the cheek region.  This is creating a shadow or bag underneath the eye.  This area can be smoothed and improved with filler treatment.  I would start with a non-surgical option given your appearance and age.I hope this helps.  


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From your photos I think skin tightening would work best. We've had success using radio frequency tightening (Thermismooth) but it might take several treatments. 
Good luck,
Dr. Norcom

Derek Norcom, MD
Portland Physician

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.