Is there anyway to remove this kind of eye bag/ dark circle? (photos)

A lower blepharoplasty would probably be necessary to reduce the fat in this area.  Also some fillers may be necessary to increase the cheek volume and blend the lid cheek junction. 

As a cosmetic oculofacial plastic surgeon practicing in Manhattan and
Long Island for over 20 years, I deal with this situation every day. I first
explain to my patients the cause of the bags. In your situation, one of your
bags is from the eyelid margin or the eyelashes to an area before the second
bags begin, which is actually a muscle called the orbicularis oculi muscle. This
muscle is activated when you smile and has the tendency to bulge when it
contracts. I don’t really recommend doing anything for that because it’s a
muscle that you need that supports the lower eyelid. We periodically do a trial
of neurotoxin like Botox® which is non-surgical and see if it contracts a
little less. However, you can’t relax it too much otherwise you are at risk of
the lower eyelid sagging.



The puffiness in the lower area despite the use of creams is due to
lower eyelid fat prolapse. From your photos, it is clear that there is a bulge
of fat that has moved forward. The procedure for that is lower eyelid
blepharoplasty. If there was a non-surgical option, then blepharoplasty would
not be one of the top 5 most popular cosmetic surgical procedures. In addition, a lot of devices are marketed to
try to non-surgically treat this area and people try to camouflage this with
all kinds of injectables. Unfortunately, at a certain point, none of those
things can really make a difference because the anatomy is very straightforward
-it’s fat that’s pushed forward. MRI studies have shown this to be fat that has
increased in volume. It generally runs in families, and I've had the privilege
of operating in 3 generations.



My recommendation would be to do a transconjunctival blepharoplasty. I
would address the fat pockets from the inside of the eyelid to avoid any
external scar. At the same time, I reduce the puffiness and create a contour
either through the removal, sculpting and repositioning of fat so that it looks
like you never had the bags to begin with. Those fat pockets don’t come back. We
perform this surgery under local anesthesia with LITE™ IV sedation in our Joint
Commission facilities in our offices.



Over 20 years, we’ve worked on developing systems and processes so that
people would not have an aversion to surgery. We do everything to make people
comfortable. Lower eyelid surgery can be complex. Unfortunately, many people do
have some complications. As a specialist, I get to fix those complications. We
get patients from around the world to have these procedures revised whether
it’s residual fat or fat transfer that have to be removed.
Patients also have lower lid retraction where the eyelid was pulled down, and
ectropion where the eyelid was everted out. In spite of all those potential
complications, it can be a remarkably satisfactory surgery when performed well
in good hands. Every surgeon has to deal with these issues no matter how good
they are and how much experience they have.



My advice is that you meet with qualified, experienced cosmetic
surgeons and have a physical exam. Determine the kind of doctor you feel has
the level of expertise, knowledge and experience that you trust to have your
eyelid surgery performed. Otherwise, you will be spending a lot of time and
money on things that are not likely to work. I hope that was helpful, I wish
you the best of luck, and thank you for your question.



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