I'm 26, is blepharoplasty for me? (photos)

Hi I can't get rid of my tire looking eyes, can't hide them with makeup I tried fillers before but not completely satisfy I want something permanent. What type of treatment should I get ?fat transfer or just regular blepharoplasty cutting the fat off. How long this can last? thank you

Doctor Answers 16

I'm 26, is blepharoplasty for me?

It appears to me that you have some fatty fullness which should be treated with a Tranconjunctival Blepharoplasty. The "dark circles" and pigmentation could be lightened with laser or peel or bleaching cream treatment.

San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews


Thank you for sharing your question and photos. The hollowing you are noticing under your eyes is a very common problem that arises with volume loss over time and can also be genetic. Although 26 is younger than average to have such severe under eye hollows, there are treatment options. Filler is usually my first recommendation for my patients with hollowing in this area to restore lost volume and camouflage the fat pad the is descending. Since you have already tried this, you may want to consider longer lasting options. As you mentioned, fat transfer is a great option and can offer significant improvement in your under eye hollows. Pending an in person evaluation, you may be a good candidate for a lower lid blepharoplasty with fat transposition. This entails redistributing the fat pads in order to refill the tear trough. I recommend consulting with a board-certified specialist to gain a better understanding of which treatments are right for you. Best of luck. 

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 67 reviews

Lower Eyelid Surgery May Help

Thank you for providing photos. I'm sorry to hear that fillers didn't provide the desired results. Lower blepharoplasty is often an appropriate treatment for patients concerned about puffiness and dark circles under the eyes. When pockets of fat are the cause, lower blepharoplasty combined with repositioning fat can produce more youthful-looking eyes. The first step is to consult with an experienced, qualified plastic surgeon to learn about all of your options.

Derek Ford, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 18 reviews

Trans conjunctival approach for lower blepharoplasty

  The photographs demonstrate herniated fat in the lower lids that are creating the puffiness look. In our practice, we do not recommend placement of fillers around the eyes due to significant complications that can occur with their placement, in addition to the only being very temporary. To permanently remove the  fatty deposits in the lower lids requires the lower blepharoplasty procedure performed thru a trans-conjunctival approach with the incision placed on the inside of the eyelid. There is no external incision. A portion of the herniated fat deposits are removed to rejuvenate the  eyelids.  For more information and many before and after results, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Fillers to conceal under-eye bags #plasticsurgery

The use of a temporary filler like Juvederm beneath the eyes will help to conceal the bulging fat pads that your photos demonstrate.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Tired Looking Eyes in 26 Y/O

The depressions you have are quite classic and usually easily corrected with fillers by a physician who is experienced in treating the area. I do not know what fillers you had or where they were placed, but, for you, at our age, fillers should be the best option. You need a heavy filler like Radiesse or Juvederm Voluma placed under the orbital rim and septum. Make sure you see an expert injector with significant experience in filling this area. (See ExpertInjector.org and plasticsurgerytoday.com/non-surgical/todays-liquid-lift-wrinkle-and-contour-correction/)

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

I'm 26, is blepharoplasty for me?

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: Botox or Dysport, temporary hyaluronic acid fillers like Restylane, long-lasting micro-fat grafts, blepharoplasties, or combinations of procedures. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient who has tried fillers without success,  a combination of a blepharoplasty and micro-fat grafts will generally produce the best and longest lasting cosmetic result.  Following the advice of anyone who would presume to tell you what to do based on limited photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person. 

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Blepharoplasty for lower eyelids

Hello, you will likely benefit from a lower eyelid blepharoplasty.  You have prominent lower lid pockets. Fillers are not likely going to help much.  You should seek a consultation with an eyelid plastic surgeon to see what long term surgical options you have. In a case like yours, a transconjunctival blepharoplasty with fat repositioning (moving some of the fat to fill the under eyelid hollows) can be very beneficial. Good luck! 

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 104 reviews

I'm 26, is blepharoplasty for me?

Your best treatment option is transconjunctival lower blepharoplasty with fat/bags repositioning. It is scar-less, quick healing, avoid eyelid malposition, keeps eye shape, removes the bags and fills in the hollow dark circles area, all at the same time, with long-term results.  Other options are fat or filler injection but not best for you, long-term.  See an oculoplastic surgeon and following link.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 73 reviews

Lower lid blepharoplasty or fillers

You have a significant tear trough, but not much fat protrusion. Removal of fat would worsen the appearance - transposition is a consideration, but you might not achieve adequate filling of the tear trough. Your previous trial of fillers may not have been satisfactory if the volume of filler was inadequate. Filler injection with appropriate volume to project the cheek, and Laser resurfacing of the lower lid to gently tighten the skin over the fat pad would improve the appearance. Seek an opinion from an experienced surgeon and injector prior to making a decision. Best wishes.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 7 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.