Should I Get a Blepharoplasty for my Eye Bags? (photo)

I am 27 years old and have had bags under my left eye since I was a child. Since it is only under my left eye it gives me a very asymmetrical look and is most pronounced when I smile. Makeup does not cover it because of all the deep lines and bulges. I have been wanting a lower lid blepharoplasty for a while, but am unsure whether I would be a good candidate. What is the best/right treatment option for my situation?

Doctor Answers 11

Lower Eyelid Bag Removal

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The bags you see on your left lower eyelid are fat that came in during puberty and are normally held back by a piece of tissue known as the septum orbitale.  For whatever reason, you have protrusion of this fat only on one side.  Your orbit may be smaller on this side, or there may be excessive fat, or your septum orbitale be weaker genetically.  At any rate, since you have no excess skin, the appropriate treatment would be to go through your lower eyelid conjunctiva (inside the lower lid), and careful removal of fat should be done so as not to create an indentation on that side.  My preference for the incision and removal of fat here would be the use of a surgical laser.  This leaves no visible scar, heals quickly with minimal swelling. 

Eye bag blepharoplasty

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The photos show herniation of the fat pads in the lower lids.  A transconjunctival approach places the incision on the inside of the eyelid. The fat bags are removed and this will rejuvenate the lower lid. Make  sure any allergies are addressed as well since they can make your eyes puffy 

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

What options are available for the treatment of under-eye "bags"?

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A transconjunctival lower blepharoplasty would permanently reduce the lower eyelid bag and can be performed safely under twilight anesthesia. Your best non-surgical option would be to use an hyaluronic acid filler such as Juvederm to fill the area and camouflage the herniated fat. This can be performed in the office with a small amount of numbing cream for comfort.

Stephen Weber MD, FACS

Herniated orbital fat

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Depending on your preference, this could be addressed with either a surgical approach [transconjunctival blepharoplasty with conservative fat excision or transposition] which will give a permanent result, vs a non-surgical approach with fillers [Juvederm or Restylane] which will give a temporary solution [6-12 months].


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

Eyelid bags

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It appears that you have mild fat herniation under that left eye.  A blepharoplasty (with the incision on the back of your lower eyelid) to remove fat only would likely solve your problem.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 12 reviews

Should I Get a Blepharoplasty for my Eye Bags?

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 Yes these are lower eyelid fat bags and a lower Blepharoplasty (Eyelid Surgery) would remove these. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Unilateral lower Blepharoplasty

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The fat herniation of the lower eyelid can sometimes be more pronounced on one side only. It is worthwhile to get one side done and achieve symmetry. If you were to wait for some reason on surgery, then you can get Restylane or Juvederm injections in the tear trough area to hold you over for a while.

In terms of your age, it is still appropriate to get the surgery done.


Dr. J



This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Palm beach blepharoplasty

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Based on the photos, it appears that you have pseudoherniation of periorbital fat. This problem can be treated with a transconjunctival blepharoplasty in which there are no external visible incisions. The surgery is done from the inside of the eyelid to avoid visible incisions and scars. The surgery itself should typically take no more than 20 -25 minutes. Postoperative swelling and bruising can be expected but mostly resolves within a week.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon

Lower Eyelid Fat Removal

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Since this is a fullness under just one eye, it may be herniated fat. At your age no skin needs to be removed, so a transconjunctical lower blepharoplasty with just fat removal is a consideration for you.

The I's

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Cosmetic Laser Surgery may be an excellent approach for many cosmetic issues in or around the periorbital region: especially for young people!  Consult your trusted Cosmetic Surgeons and discuss what's best for you.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 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.