Blepharoplasty or fillers for eye-bags? (photo)

I'm a 19 year old male. Since my mum and her family have dark circles, I believe mine are hereditary. I'm wondering if I should opt for eyelid surgery or fillers to treat them.

Doctor Answers 8

Filler or blepharoplasty for under eye hollows

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I perform quite a lot of fat grafting for the under eye area. I would not perform surgery on you at this point in your life. Your eyes are youthful and attractive.  

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Tear trough vs. mini-eyebag. Is the cup half empty or half full?

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Hi Whippersnapper,

In your photos you can see very small groove (tear trough) between your upper cheek to the lower eyelid "bag." It may be due a slightly weak cheek bone which is causing the appearance of a small eyebag.

I think it would be best to do nothing.  If you are intent on trying to improve this area, you can try some temporary filler to smooth out the groove below your very small eyebag.  What this will do is blend the side of the your nose to the eye bag for a seamless transition.

If you see a pebble on the surface of the beach if you bury the pebble, the pebble will be under the surface of the beach and appear flat.

People who have naturally high cheekbones rarely show eyebags, because their cheek protrudes further out than their lower eyelids, which makes the eyebag hard to form.

Temporary fillers come in 1 cc and half syringe sizes. My preference for this area is Restylane.  Most likely you would only use 0.15-0.25 cc to smooth that area out and blend the transition.  I have a before and after photo of a young man in his 30's with an equally small tear trough groove which needed very little filler to treat the area.

Click on the link to see an nice example of what fillers can do for a more severe eyebag.  The goal is simply to transition the cheek to the lower eyelid for a smooth appearance, so that you can not tell where the lower eyelid begins and the cheek ends.


Dr. Yang

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 35 reviews

Lower lid bags

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and the troughs underneath them can be camouflaged with filler or fat grafting (assuming you have some excesses).  Surgery would not be recommended at your age of 19 years old.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Blepharoplasty for under eye bags

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 The primary goal of the lower eyelid surgery is to remove a portion of the 3 fatty deposits creating the puffiness look. This procedure is performed through trans-conjunctival approach on the inside of the eyelid.  At age 19 there is simply not enough lower eyelid bags to be concerned about. Best to leave well enough alone at this point.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

How to fix dark cicles under the eyes?

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I have had patients similar to you, who while being young had congenital dark circles and lower eye bags. In my professional opinion the best option is to under trans-conjunctival lower blepharoplasty to reposition lower eyelid fat, with possible fat grafting of the lower eyelid margin. 

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 51 reviews

Hereditary fat prolapse

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Though your photos certainly help, an in person consultation would be much more helpful.
"Dark circles" may be due to pigment of skin, visualization of underlying muscle, prolapsed eyelid fat, and sometimes just due to shadowing due to a hollow contour.

From your photos, it seems to me that you may have mild fat prolapse with slight visualization of underlying muscle.
Though injectible fillers are excellent in this area, I believe that fat repositioning lower blepharoplasty would give you an excellent long term result, avoiding the need to perform injections repeatedly over the years. I've attached a copy of patient with fat repositioning lower blepharoplasty.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Lower eyelid "bags"

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I would recommend Restylane or Belotero to fill in the "tear trough" in the inner corner of your lower eyelids. I believe these products are safe and will give you immediate gratification.They are also reversible so if you don't like the effect then you can easily remove them.

Joel E. Kopelman, MD, FACS
Ridgewood Oculoplastic Surgeon

Blepharoplasty or fillers for eye-bags?

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Because of your age and anatomy I doubt anything you have mentioned would be of the slightest benefit at this point.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.