My eyes always look tired. What procedure or service could help my undereyes? Lower bleph? (Photo)

Question

From Auckland New Zealand Nearly 40 yrs old of West Indian, pacific and German/Scottish descent. Overall my skin I think is quite good for my age but I have always suffered from bags and/or dark circles. The bags are very puffy and have increased in size also even more so over the last few years. I look tired constantly, makeup does next to nothing to hide them protruding out. It’s all I see in the mirror and photos and I am highly insecure about my face now, what can I do?

Jeffrey M. Darrow, MD · Answer

Let’s start with the positives! Your brow position is excellent. Your upper eyelids are youthful and symmetrical. Your lower eyelid position is correct. You simply have a small amount of pseudoherniation of the fat from your lower eyelids. This should be easily corrected with a lower  blephroplasty under either local anesthesia or general anesthesia. This will smooth the transition between your lower eyelid and your cheek and give you a more youthful and rested appearance. Have a detailed discussion with your plastic surgeon. Best wishes.

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

Camille Cash, MD · Answer

From the photos it appears you have a few options to improve the under eye area.  Fillers are one option to help smooth contours.  The treatment is done in the office with results lasting up to a year.  Lower blepharoplasty is a surgery that will address the fat herniation and any excess skin under the eye for a more permanent solution.  Morpheus8 is another potential treatment which uses RF technology combined with microneedling to improve overall skin tone and texture.  See a board certified plastic surgeon near you to learn more about your options.

Gary M. Horndeski, MD · Answer

You have prominence of fat underneath the eyelids and this is separate from the bulging.  You would benefit from a lower blepharoplasty and release the septum to allow the fat to transfer to the tear trough and diminish the prominence you dislike.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

From the photos provided, it appears that a robust HA volumizing filler would work well for contouring the face, and at the same time improving the under-eye areas and diminishing the smile lines. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert, since expertise and experience are required by the injector to ensure that the specific contours of the female face are preserved, so as not to inadvertently masculinize the face. Hope this helps and best of luck.

My eyes always look tired. What procedure or service could help my undereyes? Lower bleph? (Photo)

Answers (6)

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

Answer: Consider A Robust HA Volumizing Filler For The Cheeks To Improve Cheek Contour & Under-Eye Hollows/Bags

Answer: Consider A Robust HA Volumizing Filler For The Cheeks To Improve Cheek Contour & Under-Eye Hollows/Bags

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Everything you need to know about Eyelid Surgery

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My eyes always look tired. What procedure or service could help my undereyes? Lower bleph? (Photo)

Answers (6)

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

Answer: Consider A Robust HA Volumizing Filler For The Cheeks To Improve Cheek Contour & Under-Eye Hollows/Bags

Answer: Consider A Robust HA Volumizing Filler For The Cheeks To Improve Cheek Contour & Under-Eye Hollows/Bags

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.