Under eye bags, best treatment? (Photo)

I'm 53 with really bothersome under eye bags, what would be the best course of treatment for long term results? I have seen 3 PS all with different opinions. Please help I'm so confused.

Doctor Answers 13

Under eye concerns

You are dealing with two separate issues.  You have eye bags as well as malar bags.  The under eye bags are treated with lower blepharoplasty surgery.  Its purpose is to remove excess skin and smooth the under eye area.  Malar bags are tricky.  Some patients see improvement with laser treatments.  

Under eye concerns

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You are dealing with two separate issues.  You have eye bags as well as malar bags.  The under eye bags are treated with lower blepharoplasty surgery.  Its purpose is to remove excess skin and smooth the under eye area.  Malar bags are tricky.  Some patients see improvement with laser treatments.  

Under Eyes Bags (Festoons)

Hi and thanks for sharing your question! I routinely treat patients with bags under the eyes with injection of fillers. However in you case and based on the picture, you seem to have festoons which are tricky to treat with fillers and I usually do not recommend filler in these cases. It would be best to see a surgeon with experience in procedures around the eyes. I hope it helps and good luck!

Under Eyes Bags (Festoons)

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Hi and thanks for sharing your question! I routinely treat patients with bags under the eyes with injection of fillers. However in you case and based on the picture, you seem to have festoons which are tricky to treat with fillers and I usually do not recommend filler in these cases. It would be best to see a surgeon with experience in procedures around the eyes. I hope it helps and good luck!

Under eye bags, best treatment?

You do have eye bags worse on the left side which can be treated with trans-conjunctival blepharoplasty.  However it is very very important  to understand that you have malar bags, the bags below the eyelids on the cheeks.  These malar bags are almost impossible to correct and in some cases removal of the eye bags can make the malar bags look worse.  Please consult a board certified oculoplastic surgeon for advice.

Under eye bags, best treatment?

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You do have eye bags worse on the left side which can be treated with trans-conjunctival blepharoplasty.  However it is very very important  to understand that you have malar bags, the bags below the eyelids on the cheeks.  These malar bags are almost impossible to correct and in some cases removal of the eye bags can make the malar bags look worse.  Please consult a board certified oculoplastic surgeon for advice.

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Eye bayas and malar festoons

Obviously a personal exam is necessary but from the picture it seems that you have two different issues. Lower eyelid bags and malar festoons. The eye bags treatment is pretty straightforward and is better accomplished with a transconjunctival lower blepharoplasty. The malar festoons are more difficult to treat but usually respond well to CO2 laser resurfacing. A well done direct excision is another option leaving a scar that is usually invisible after a couple of months.

Eye bayas and malar festoons

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

Obviously a personal exam is necessary but from the picture it seems that you have two different issues. Lower eyelid bags and malar festoons. The eye bags treatment is pretty straightforward and is better accomplished with a transconjunctival lower blepharoplasty. The malar festoons are more difficult to treat but usually respond well to CO2 laser resurfacing. A well done direct excision is another option leaving a scar that is usually invisible after a couple of months.

Eye bags treatment, blepharoplasty, festoons

Aging around the eyes is a complex, multifactorial process that requires extensive understanding of the anatomy. Based on the photo you submitted, it looks like you have 1) crepey lower eyelid skin, 2) lower bags, worse on left than on right, and 3) festoons. 

Each of these components requires a different treatment, but my approach is to treat the crepey skin with laser, the lower lid bags with a blepharoplasty, and the festoons with an injectable called Sculptra. Each component of the aging requires different treatments, and together they will produce vast improvement. 

One reason for the different opinions is because there are different ways to address the same problem. Some people cut out festoons, other people treat it was laser. I think both of those have significant disadvantages compared to Sculptra, and I'm happy to talk to you about why the treatment approach I recommended above works well for my patients.

Eye bags treatment, blepharoplasty, festoons

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

Aging around the eyes is a complex, multifactorial process that requires extensive understanding of the anatomy. Based on the photo you submitted, it looks like you have 1) crepey lower eyelid skin, 2) lower bags, worse on left than on right, and 3) festoons. 

Each of these components requires a different treatment, but my approach is to treat the crepey skin with laser, the lower lid bags with a blepharoplasty, and the festoons with an injectable called Sculptra. Each component of the aging requires different treatments, and together they will produce vast improvement. 

One reason for the different opinions is because there are different ways to address the same problem. Some people cut out festoons, other people treat it was laser. I think both of those have significant disadvantages compared to Sculptra, and I'm happy to talk to you about why the treatment approach I recommended above works well for my patients.

Under eye treatment

Thank you for your question.  I see two separate issues on your photo.  First, there is some bulging of the lower eyelid fat pads.  The definitive treatment for this is a lower eyelid blepharoplasty, which is the surgical removal/ repositioning of the lower lid fat pads to remove the bulges.  The second, more noticeable issue, are the festoons.  Treatment of festoons can be tricky and there is not necessarily one treatment approach, as you've learned having visited several specialists with varying opinions.  The treatment for festoons can range from laser skin resurfacing and dermal fillers to surgery, among others.  Best wishes.  

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Under eye treatment

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Thank you for your question.  I see two separate issues on your photo.  First, there is some bulging of the lower eyelid fat pads.  The definitive treatment for this is a lower eyelid blepharoplasty, which is the surgical removal/ repositioning of the lower lid fat pads to remove the bulges.  The second, more noticeable issue, are the festoons.  Treatment of festoons can be tricky and there is not necessarily one treatment approach, as you've learned having visited several specialists with varying opinions.  The treatment for festoons can range from laser skin resurfacing and dermal fillers to surgery, among others.  Best wishes.  

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Under eye bags treatment options

There are generally three methods to reduce lower eyelid bags and wrinkles.

1. Utilizing peels, lasers or any other ablative or semi ablative techniques to stimulate new collagen growth. Though effective, most people want to have little to no downtime and in order to get a very effective result with which most patients would be extremely satisfied, these techniques will fall short of their stated goals. These techniques are wonderful if they are utilized in an appropriate strength. 

2. Carefully injecting a temporary filler (such as Belotero® or Restylane®) underneath the skin in hollow areas with magnification. This could be quite effective but does involve the risk of producing irregularities and lumps and will necessitate a certain amount of bruising. A permanent filler such as Bellafill ® or even a fat transfer utilizing purified fat from your body are also options.

 3. Performing a simple surgery under local anesthesia called a pinch blepharoplasty. In this operation, a small strip of skin is removed directly underneath the lower eyelash line and results in a nearly invisible scar. The recovery is very rapid (a couple of days) and involves one single stitch which is removed in five days. This approach is actually the least complicated in appropriate hands and will produce the most consistent and significant of results in reducing lower eyelid bags and wrinkles.

Under eye bags treatment options

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

There are generally three methods to reduce lower eyelid bags and wrinkles.

1. Utilizing peels, lasers or any other ablative or semi ablative techniques to stimulate new collagen growth. Though effective, most people want to have little to no downtime and in order to get a very effective result with which most patients would be extremely satisfied, these techniques will fall short of their stated goals. These techniques are wonderful if they are utilized in an appropriate strength. 

2. Carefully injecting a temporary filler (such as Belotero® or Restylane®) underneath the skin in hollow areas with magnification. This could be quite effective but does involve the risk of producing irregularities and lumps and will necessitate a certain amount of bruising. A permanent filler such as Bellafill ® or even a fat transfer utilizing purified fat from your body are also options.

 3. Performing a simple surgery under local anesthesia called a pinch blepharoplasty. In this operation, a small strip of skin is removed directly underneath the lower eyelash line and results in a nearly invisible scar. The recovery is very rapid (a couple of days) and involves one single stitch which is removed in five days. This approach is actually the least complicated in appropriate hands and will produce the most consistent and significant of results in reducing lower eyelid bags and wrinkles.

Best procedure to reduce eye bags and dark circles

The best short-term and long-term treatment for both under eye bags and hollowness is tranconjunctival lower blepharoplasty with fat/bags repositioning, so the existing fat/bags are repositioned to fill the hollow area. See follow surgical video and website link. Skype consult available. However, you also have festoons which are more difficult to correct and will likely require some skin removal as well.

Best procedure to reduce eye bags and dark circles

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

The best short-term and long-term treatment for both under eye bags and hollowness is tranconjunctival lower blepharoplasty with fat/bags repositioning, so the existing fat/bags are repositioned to fill the hollow area. See follow surgical video and website link. Skype consult available. However, you also have festoons which are more difficult to correct and will likely require some skin removal as well.

Under eye bags, best treatment?

Surgical removal of undereye fat pads is the best treatment option in 2017. Please consult a board certified plastic surgeon for a consultation. 

Manjula Jegasothy, MD
Miami Dermatologist
4.7 out of 5 stars 12 reviews

Under eye bags, best treatment?

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

Surgical removal of undereye fat pads is the best treatment option in 2017. Please consult a board certified plastic surgeon for a consultation. 

Manjula Jegasothy, MD
Miami Dermatologist

Eye bags

Eye bags may be partly inherited , they  are also a natural part of the aging process . These can be improved with a lower lid blepharoplasty or lower lid eye tuck . The specific steps of this procedure will be customized to your Anatomy and will be reviewed  during your consultation with a Plastic Surgeon ,certified by the American Board Of Plastic Surgery .

 

Eye bags

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

Eye bags may be partly inherited , they  are also a natural part of the aging process . These can be improved with a lower lid blepharoplasty or lower lid eye tuck . The specific steps of this procedure will be customized to your Anatomy and will be reviewed  during your consultation with a Plastic Surgeon ,certified by the American Board Of Plastic Surgery .

 

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.