Recently developed prominent bag under one eye - filler, or is blepharoplasty the only way? (Photo)

Question

I'm 52, btw, so likely in need of upper bleph, but could I improve the one bag non surgically for the time being?

William Portuese, MD · Answer

From the one limited photograph, you have herniated fat pads in both eyelids, just one eyelid is worse than the other. A trans-conjunctival lower blepharoplasty can accomplish The fat bag removal from the inside of the eyelid without any external incisions. Choose your surgeon wisely based on lots of experience producing natural results

Gurkan Kayabasoglu, MD · Answer

Hello. You can temporarily reduce the problem with your lower eyelids with fillers for a very short time, but as long as you have fat bags, fillers cannot make you very happy. The right thing for you is a combination of lower eyelid and upper eyelid without repose/transposed fat resection.You can also book an online consultation and discuss your problems with me. With all respect.

Sam Speron, MD, FACS · Answer

This is a common question.  Upper eyelid hooding can be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you.

Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.

The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day, you can shower the next day and most patients take no pain medicine. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Edward Buckingham, MD · Answer

Correction of lower eyelid concerns can be achieved through surgical and non-surgical treatments. Options are dependent on the anatomy of the individual, as some patients will not benefit from non-surgical treatments despite trial with dermal fillers. We recommend an in office evaluation where you and your provider can determine the treatment option best for you.

Zachary Farhood, MD · Answer

The answer this question depends on how much of an improvement you are hoping for. I notice a significant discrepancy between your right lower lid and your left lower lid. Some filler on the left could soften the area slightly, but it would not be near the appearance of your right lower lid if overfilled could look puffy and unnatural. Surgery would be a great option to address your eyelids.

Michael I. Echavez, MD · Answer

You have some puffiness under both eyes, but it is worse on one than the other.  This issue is caused by fat that is protruding under the skin.  Lower eyelid surgery could be done to directly address this protruding fat and would produce the longest lasting results.  It is possible that a filler could be used to be placed under the puffy area to try and camouflage it.  This would be the non-surgical option.

Thomas A. Mustoe, MD, FACS · Answer

The bag represents fat bulging. Adding fat to the depression below tne fat bulge will help but the best result Woukd be to remove some fat combined with fat transfer.  Fat rearrangement through a blepharoplasty approach also works but in my hands is less predictable with a longer recovery.

Tanya T. Khan, MD · Answer

Hello, the one side does appear to be fuller than the other. Both have what we call fat prolapse. Given the extent of the puffier side, you would do best with a lower blepharoplasty to remove fat (can be done without a visible scar through the back of the lower eyelid). Would not recommend filler because of the visibility and position of the fat pads.  Please see an oculoplastic surgeon for best results.

Carrie L. Morris, MD, FACS · Answer

If you truly have a prominent fat pad of your lower eyelid (difficult to tell from the photo), then the only solution is a lower blepharoplasty. Filler will not solve your problem and only look worse. However, it appears that you have both a fat pad (volume excess) and a tear trough (volume loss). In this case, I recommend lower blepharoplasty first, then 6 weeks or more later after the swelling has resolved, filler to the tear trough.

Renata Khelemsky, MD · Answer

Eyelid BagsYes you absolutely can! I encourage most patients to "test drive" the look of lower eyelid surgery with a minute amount of HA filler. Note that the choice of filler, and the technique, are paramount to a successful result. Many providers do not have surgical experience in this region, and cannot deliver a successful result. I recommend a surgical provider to help you achieve the best result with dermal filler. I hope that helps!

Recently developed prominent bag under one eye - filler, or is blepharoplasty the only way? (Photo)

Answers (11)

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