Should I Get Blepharoplasty or Filler in the Tear Trough?

I am 25 and I have bags under my lower lid and i hate them! I have seen few surgeons in London some said Blepharoplasty or Filler in the Tear Trough? I am really confused what I should do! This is genetic and my mum and dad have them as well also few other member of the family has them too! Can you please suggest me what is the best option for me! thanks

Doctor Answers 13

Filler does not effect lower lid fat!

Lower lid surgery can reduce and transpose fat into the tear trough producing a long term correction.  Fillers injected into the trough camouflages the protruding fat is temporary, although swelling can be prolonged if over corrected.

In your case my recommendation is lower lid surgery.

Brampton Plastic Surgeon
5.0 out of 5 stars 9 reviews

Should I get Blepharoplasty or filler for lower eyelid bags?

 Fillers will hide the leading edges of the lower eye bags but only a lower Blepharoplasty can remove these bags permanently.  At 25 years old, you have a long time ahead of you to use temporary might consider the Lower Blepharoplasty to remove the bags once and for all.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

What to do for lower lid bags

Without pictures, it is difficult to say for sure what would be best for you.  In all liklihood, either would work.  A filler would have to be repeated, whereas surgery would be more permanent. In my experience, with younger patients with familial lower lid bags, a transconjunctival approach works very well.  This is done from the inside of the lid and leaves no visible scar. Fillers in the lower lids tend to last longer than in other areas, usually at least 12 months and sometimes 2 years.  Even so, over the long run the cost of the filler may be more than surgery.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 29 reviews

Blepharoplasty vs Filler injections

Reading through the postings just about everyone has asked for a photograph. There is a good reason for that. In many patients this is really a judgment call. There are patients who are borderline and would profit from either one. Obviously the filler injections are temporary whereas properly performed lower eyelid surgery done from the inside without a scar in a young person can last you the better part of your adult life. It sounds like this is really a family trait and without seeing photographs I would lean more in terms of surgery. Hope this helps

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

Blepharoplasty vs. tear trough filler.

I would need to see  photos and then I could easily answer your question. In general if you have bags in the lower eyelid the best way to treat them is by removal. Fillers are in patients with tear trough and from your age I doubt it that is you!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Options for surgery vs injectable fillers

To make this choice of necessity would be a careful clinical exam to determine what the problem is: it sounds like you likely have a familial excess fat which would respond well to a lower lid blepharoplasty ( I like to perform these through a "subconjunctival" approach i.e. on the inside of the lower lid) this would alleviate a scar and the excess fat could either be removed or repositioned or both.  Fillers have their place but are less long lasting that the surgery (when the surgery is appropriate) and one has to be very careful with the placement of the filler in the tear trough area- fortunately the fact that fillers are temporary also is helpful in the event of problems with the filler placement.  I would obtain several consultations from plastic or oculoplastic surgeons before making your decision.

Jerry Lugger, MD
Southlake Plastic Surgeon
5.0 out of 5 stars 3 reviews

Lower Lid Surgery vs Filler Injection


Whether you have lower lid surgery or filler injection will depend upon:

1) Your anatomy.  At your age, you probably have fat prolapse and not excess skin, so either procedure will work.

2) How much risk you are willing to accept.  Every procedure has some risk.  Lower lid surgery has a low complication rate, but it is slightly higher than the complication rate for fillers.

3) How long you would like the procedure to last.  I tell patients that Restylane injections to the lower lids last about a year.  Surgery is not permanent, but it will probably last 5-10 years.

4) How much you are willing to spend.  Although filler injection needs to be repeated, it is much less expensive than surgery

Best of Luck,

Dr. McCracken

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

In most patients, a well-performed Injectable Filler treatment may be best to improve the appearance of your lower eyelid bags.

It's difficult to advise you without seeing a photo, but most young patients like yourself with lower eyelid bags may benefit from an Injectable Filler treatment. I almost never remove lower eyelid fat anymore since this may lead to a hollow, "operated" appearance.

My personal preference for "tear trough" filling is to use Silikon-1000, an off-label filler for permanent results.

I hope this is helpful for you.

Regards from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Lower eyelid dark circles

The answer depends on exactly how your eyelids are in relation to the relative "bags" and relative "hollowness" underneath it.  It also depends if you want something more longterm (surgery) or something less invasive but short term (fillers).

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Lower eyelid surgery is indicated for excess fat

It sounds like you have excess fat in your lower eyelid area which is likely genetic. This fat typically needs to be repositioned (not removed) in order to restore a natural lower eyelid/cheek contour. This is usually done through an incision on the inside of the lower eyelid (transconjunctival). A board certified plastic surgeon can explain this to you in greater detail during your consultation.

Fillers are only useful for filling in tear trough areas, not for lower eyelid bags.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 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.