Best way to remove fat from lower eyelids? (Photo)

Question

I have had eye bags since I was 15. Am 21 now. Am I a good candidate for surgery and what can be done?

Nelson Lee Novick, MD · Answer

In this day and age with so many simple nonsurgical aesthetic procedures replacing invasive surgical procedures (for example, there are now nearly 2.5 million hyaluronic acid injections performed annually in the U.S. alone), I am surprised that you are jumping to considering relatively expensive surgery (especially at your young age) with significant downtime and recuperation periods before exploring potential nonsurgical approaches that are less expensive and engender little to no downtime. For years now, fillers have been used to fill tear troughs and camouflage bags under the eyes. In my Upper East Side Manhattan practice, I routinely use Belotero Balance for treating this area, owing to its negligible propensity to give rise to the unwanted bluish Tyndall Effect when injected superficially into the delicate tissues under the eyes. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would opt for Teosyal Redensity II or Aliaxin FL for this purpose). The under eye region is not a place to be left to novice injectors trained only in using plain Juvederm or Restylane  to treat simple smile lines. It is a very advanced injection technique, so you would be wise to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in treating this cosmetically important area. And make certain to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck to you.

Mehryar (Ray) Taban, MD, FACS · Answer

You actually don't want to remove the fat as it will cause hollow sunken eyes but rather redistribute the fat, namely transconjuctival lower blepharoplasty with fat repositioning. See following surgical video and website link.

Brett S. Kotlus, MD, MS, FACS · Answer

These days, it's less common to simply remove lower eyelid fat.  It most situations, I preserve the fat by shifting it into the under-eye hollows (also called the tear trough).  This is done from an incision behind the eyelid so there is no visible scar.

James C. Marotta, MD · Answer

It appears you have puffiness caused by bulging fat at a very young age.   This can be treated by conservatively reducing the fat through a hidden incision inside the lower eyelid (transconjunctival approach) with no external scars.  This should improve your eyelid appearance for many years to come and if done properly will not cause eyelid hollowing.

Vincent N. Zubowicz, MD · Answer

The picture presented has limited information but it looks as though if lower lid surgery is considered the fat should be translocated below the orbital rim for volume enhancement. This is fairly simple to do and has become a mainstay in many patients undergoing blepharoplasty.

Malena Amato, MD, FACS · Answer

Even at your young age, some people have hereditary fatty bags, which can be bothersome. Options include filler of the crease below the bags, or transposing the fatty bags into the deeper space from an incision inside the eyelid to avoid an external scar. It would be ideal for you to seek a consultation with a surgeon specialized in eyelid surgery and non-surgical treatments.

Joel E. Kopelman, MD, FACS · Answer

Hello there. Lower eyelid surgeries are not uncommon these days. I would recommend a lower eyelid blepharoplasty, probably a transconjunctival procedure that involves an inner incision to help reduce the fat in the lower eyelids. You could consider fat redistribution, rather than complete removal. Another option is the use of a filler such as Belotero Balance.

Reza Momeni, MD, FACS · Answer

In my experience patients like you can be well treated with lower eyelid blepharoplasty with a transconjunctival approach.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.

William B. Rosenblatt, MD · Answer

It is very common for people to have inherited this trait. We usually get rid of the fat through a small incision inside the lower lid so there is no scar. Often times the results last your life time and  you look much better without the bags. At an in person consultation, I will show you other photos that look just like you -- before and afters.

William Portuese, MD · Answer

It is very unusual to undergo a lower blepharoplasty at age 21. The best way to remove fat when necessary is through  the lower eyelid by a a trans conjunctival approach located on the inside of the  eyelid. This procedure is performed under general anesthesia as an outpatient procedure. For more information many examples, please see the link and the video below

Best way to remove fat from lower eyelids? (Photo)

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More Eyelid Surgery Questions

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Answers (11)

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