Thick raised bulges under eyes! What can I do?

Question

When I smile, these ridges form under my eyes…I absolutely hate them and they make me feel so ugly. I have tried under eye filler twice, neither time worked to get rid of these bulges. They look like veins but are not. I have also gotten Botox (bunny area) which did soften to a degree but did not rid them completely. They are flat until I move my mouth. Can anything be done?

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgeons typically do not treat expressions that form in a dynamic state.
Other words, we don’t treat the way you look when you contract muscles of facial expression.
We typically make assessments and come up with treatment plants based on what the face looks like in a static or expression less state.
Attempting to treat what your face looks like when you smile is most likely going to have less than perfect outcomes when you don’t smile.
 I think your best option is to accept the way your face looks when you smile and recognize that this is part of showing positive emotions.
Best,
Mats Hagstrom MD

Thick raised bulges under eyes! What can I do?

Answers (2)

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