I'm 35 and unhappy with bags under my eyes constantly. What options do you recommend? (Photo)

Bleth surgery?

Doctor Answers 15

Fillers

I always recommend starting with a non-surgical option first. It's less invasive. I would recommend a HA filler such as Restylane to fill in the tear trough area, restoring youthful volume and demising the appearance of dark circles. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 52 reviews

Bags under eyes

Based on the picture, I would recommend transconjunctival lower blepharoplasty, release of arcus marginalis and fat redistribution. Done well, this gives precise, consistent and very satisfied results.

Eric In Choe, MD
New York Plastic Surgeon
4.6 out of 5 stars 49 reviews

Surgical: Lower blepharoplasty with conservative fat removal. Non-surgical: HA fillers using cannula

Judging from the picture, you have minimal eyelid skin wrinkling and very shallow tear trough if at all.  You would be an excellent candidate for lower blepharoplasty with minimal fat removal without the need for fat "repositioning".  Nonsurgical option would be to "fill" the depression or valley using a hyaluronic acid filler Restylane or Belotero.  The cannula is a blunt-tip micro-instrument to minimize bruising and pain during injection and significantly reduces the risk of intra-vascular injection.

Johnny Mao, MD, FACS
Orange Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

This can be improved with lasers and fillers in my practice but surgery is always an option.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Reducing Undereye Bags

As young as you are, and as pretty as your almond shaped eyes are, I would favor an approach that reduces the fat excess in your lower lids, while sparing an incision through the skin. Your youthful skin will likely respond well and recoil once the prominent fat is removed from the inside of your lid. The possibility of layering in fat to further soften the appearance can be determined during an in person consult. Bottom line...I recommend a conservative approach to maintain the shape of your beautiful almond shaped eyes.

Fillers

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

I'm 35 and unhappy with bags under my eyes constantly.

You may want to consider transconjunctival lower blepharoplasty to remove or reposition the under eye bags (fat). See link below for more information.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 62 reviews

Lower lid blepharoplasty versus fillers

 This is a great question and is very commonly asked in consultation.  Both filler and lower lid blepharoplasty would be options for you, and there are pros and cons to both. 

 Filler is a nice, non-surgical option to camouflage the bags in this area.  When performed by the proper injector, it looks very natural, and the results can last up to a year.  If for any reason you're unhappy with the results, it can be easily dissolved.  This is a more advanced area for filler injections, so make sure you are choosing somebody with experience who knows the right products to put there. 

Lower lid blepharoplasty is a more definitive option for treatment, and the techniques to perform this have a come a long way since the old-school way of cutting through your skin to access those fat pads.  The transconjunctival approach allows easy access to the fat pads without having to put any extra little incisions,  in the old risks of lower eyelid malposition are significantly reduced.  Through this technique, the fat can be manipulated and placed in the proper location, which will leave you looking good for many years to come instead of just cutting the fat out and leaving you looking hollow later.

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 78 reviews

Under eye bags

Thanks for your question. Based on your photo which is a bit limited, you would benefit from either tear trough fillers or a conservative lower eyelid blepharoplasty, to remove a small amount of prolapsed fat in the lower lids.

Sean Maguire, MD
Louisville Facial Plastic Surgeon
4.7 out of 5 stars 20 reviews

Under eye bags

You have some fat prolapse in the lower lids, and a prominent tear trough.  The easiest solution is some filler into the tear trough to mask the fat and smooth out the area.  HA filler such as Restylane or Belotero work well for this.  They can last at least one year. Juvederm is not a good choice in the lower lids as it can create long term edema.
The more permanent solution is a lower lid blepharoplasty with fat repositioning.  The fat is moved down into the tear trough.  At the same time some skin is removed or lasered.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 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.