Your appearance is very typical of the aging lower eyelid. The fat within your eye is no longer well contained and is protruding forward, causing puffiness or "bags" under the lower eyelid. You also have age-related fat loss in the upper cheek and at the corners of the eye. These changes result in an uneven contour of "hills and valleys", which is not youthful. There are many surgical and non-surgical methods that can be used to improve your appearance. I think the best result combines surgery (to reduce or redistribute the fat bags under your eyes) and injections of fat (or filler) to correct the areas of volume loss or deflation. If you are not ready for surgery, you can achieve a nice improvement with fat or filler alone. Best of luck.
Lower eyelids surgery candidate to address puffy eyes
You are a good candidate for lower blepharoplasty. Fillers would not be good option for under your eyes, but you may want to balance your face with voluma injected into the cheeks to address the volume loss.
Lower eyelid bags- filler vs surgery
On your photo, I can see that you have a combination of volume loss in your lower eyelid/cheek area as well as protruding fat bags in the lower eyelid. You would do well, with lower eyelid surgery to remove the fat bags, and adding some filler in the cheek area. There are pros and cons of each procedure.
If you look on my real self profile you will see some befores and afters of two patients with lower eyelid problems, one male treated with surgery (his bags were bigger than yours) and the other is a female patient treated with filler and lower eyelid laser. Similar problems treated with different options, both with great results. A consultation with a plastic surgeon with lots of experience in this area will be your best option to explain what would be best for you. Good Luck!
Lower eye lid surgery for puffy eyelids
The photograph demonstrates herniated fat through the orbital septum in all 3 compartments of both lower lids. To rejuvenate the lower lids, a conservative amount of fat is removed from the inside of the eyelid, also known as a transconjunctival approach. When excess skin is present, a incision is made on the outside of the eyelids directly below the eyelashes to pinch the excess skin. In our practice, this incision is closed with tissue glue. For many examples and more information, please see the link below
What can I do for lower lid bag?
You are a perfect candidate for lower lid blepharoplasty! The surgery is designed for this specific problem. When the bags get too big like yours, the filler placed to attempt to camouflage just leads to bigger bags. Filler would not help this, but the good news is surgery will fix it for good!
What can I do about my lower eyelids?
Thanks for your question and photo. It looks like you have lower lid fat pads that would be very amenable to a surgical lower lid blepharoplasty. This surgery may be sufficient to achieve a more rested look and is associated with a fairly short and easy recovery (usually about one week out of work. You also have some cheek volume deficiency (the "valleys" below the "mountains" of puffy fat) that could benefit from filler injection or fat grafting at the time of surgery to make the lid-cheek junction more youthful.
Be sure and consult with an experienced board certified plastic surgeon, facial plastic surgeon or oculoplastic surgeon (or two) to learn your options. Best wishes.
From these photos, it looks like you would get a homerun result with a lower lid a TC blepharoplasty. In my experience the most important thing in assuring a quick recovery from blepharoplasty is minimizing bruising and swelling. Bruising is much easier to prevent that to get rid of. I have all my patients ice as much as possible from the time they get home until they go to sleep that first night. And I instruct them to not recline any more than 45 degrees until they go to sleep that night. And stay away from salt. Patients who follow these instructions generally heal very quickly with little or minimal bruising or swelling. Good luck, Dean Vistnes.
Treatment of Puffiness of the Lower Eyelid.
What you have is classic changes of aging of the lower eyelids. This can be treated with either injectables like fat or a heavy filler like Juvederm Voluma or Radiesse or by surgery. Each has its own risks and complications and benefits. See an experienced plastic surgeon in both surgical and nonsurgical eyelid rejuvenation and discuss this at length.
It looks to me like you have some fat bulging in the lower lids and a loss of volume in the upper cheeks. I would likely remove some lower lid fat and graft fat into the upper cheeks.
What can I do about my lower eyelids?
Most expert experienced artistic plastic surgeons have a
variety of procedures, both non-surgical and surgical, at their disposal to
produce excellent cosmetic results in the appropriately selected patient: Botox
or Dysport, temporary hyaluronic acid fillers like Restylane, long-lasting
micro-fat grafts, blepharoplasties, or combinations of procedures. Each has
benefits and drawbacks and depends on desired outcome and individual anatomy.
In a patient with your inherited anatomy, a
blepharoplasty will produce the best and longest lasting cosmetic result.
Following the advice of anyone who would presume
to tell you what to do without seeing photos and without taking a full medical
history, examining you, feeling and assessing your tissue tone, discussing your
desired outcome and fully informing you about the pros and cons of each option
would not be in your best interest. Find a plastic surgeon that you are
comfortable with and one that you trust and listen to his or her advice. The
surgeon should be certified by the American Board of Plastic Surgery and
ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).
You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California