Which Would be the Best Option, Blepharoplasty or Filler? (photo)

I am 36 fair-skinned with very thin skin with less than optimal elasticity. I have bags under my eyes that are far worse in the morning compared to the evening hours. I also have dark eye circles. I have fairly prominent cheek bones. Do I need Blepharoplasty or filler? I'm tired of ALWAYS looking tired no matter how much I sleep.

Doctor Answers 8

Which Would be the Best Option, Blepharoplasty or Filler?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your photos, at rest, do show some minimal lower eylid bags.  These could be treated with a lower eyelid surgery.  Fillers, can be added to soften the leading edges, of these bags but this will add volume, to the area, not reduce it.

Correction of lower lid contour

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From your photographs it appears there is little to no fat pseudoherniation at the lower lid.  The problem is primarily some volume loss in the midface creating a contour change (depression) between the lid and the cheek mound.  This is correctable with volume enhancement by injectable fillers which will be a less complicated procedure for you and should cause no down time.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Under-Eye Hollowness

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You raise an important question - for yourself and for many other patients with similar issues.

Although it is "easy" to remove some fat from the lower lid region and reduce the bags, I do not think that this will achieve the right look for you. You have already prominent eyes (as far as I can tell from the photograph) and filling of the hollowness beneath would likely provide a softer and more pleasing look. Injectable hyaluronic acid fillers are one option; fat grafting is another choice. This tear-trough region is the most delicate area to treat and I would strongly recommend to see a cosmetic facial surgeon who regularly deals with the complexity of the lower lid-cheek region.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 51 reviews

Dark circles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is difficult to be certain based on the photos you provided, but I think fillers would be a better option for you since you have lost volume beneath your lower eyelids, more than fat prominence.

No surgery for you

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Lower blepharoplasty is risky surgery and not to be taken lightly.  You for sure would be taking on almost all risk for very little benefit and your expectations would almost certainly not be met by surgery.  A combination of medical grade skin care, Botox, and fillers will be safer and at least as beneficial if not more so.

Fillers or surgery for the lower lids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

from what you are describing and what I see on your photos, I believe fillers would be a smarter and safer option. Surgery can correct some of the issues, but surgery is more risky and the degree of correction you need can be performed with fillers, having less risk and less down time.

Filler v. surgery for lower lids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think you'd be a good candidate for a prelimnary trial of Restylane and are not ready for surgery at this time.  The one advantage of the filler, besides its low cost and lack of downtime is that, at a later point, you can always have surgery.  I recommend that you see a board certified plastic surgeon in consultation to evaluate your options.

Filler versus eyelid lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fillers would be a better option than surgery based on your photos. Find a board certified plastic surgeon experienced in lower lid augmentation.

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.