Can Botox or fillers get rid of under eye bags?

Question

I'm 23 years old and I have really puffy bags under my eyes and when I smile there are lines on the bags if that makes any sense. It really makes me look old. Can Botox or fillers get rid of them?

Jason Emer, MD · Answer

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately. All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Jessica Lattman, MD · Answer

Botox and fillers are excellent ways to non surgically treat under eye hollows and wrinkles.  I would suggest a consultation with an oculoplastic surgeon to have a full exam.

J. Jason Wendel, MD, FACS · Answer

Thank you for your
question.Without a photo it is difficult to tell if fillers will be the best option for you. Hyaluronic acid based fillers are a great non-surgical option to add volume and help soften the appearance of under eye bags. To be sure what will work best for you, see two
or more board-certified providers in your area for a complete evaluation to
make sure you are a good candidate and that it is safe for you to have
treatment.

I hope this helps.

Mitesh Kapadia, MD, PhD · Answer

Facial fillers can often help camoflage under eye bags. If you want a personalized recommendation, please post photos.

Afshin Farzadmehr, MD · Answer

Lower eyelid fat pad removal may be the best permanent solution.  Minimal 1-2 day downtime.

Elliot M. Heller, MD · Answer

You may want to talk to a doctor to see if fillers may work for you. Maybe talk to them about Belotero, or what other fillers they recommend. this is something that you do not need surgery for unless it is necessary.

Camille Cash, MD · Answer

Botox and fillers work differently.  Botox is commonly used at the crow's feet area to soften lines at the sides of our eyes.  Fillers help to disguise contour irregularities and to improve symmetry.  I encourage you to meet with an expert injector near you to discuss options.

Robert Singer, MD · Answer

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.

Following the advice of anyone who would presume
to tell you what to do without seeing 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))
or the Canadian Society for Aesthetic Plastic Surgery (CSAPS)  .
You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Gerald Wittenberg, MSc, DMD (retired) · Answer

Yes, at your young age, fillers work well to blend the tissues so they look uniform and natural. The fillers add volume to the areas which are showing 'lines and grooves' and it can be done artistically so very small droplets are added to maintain the look for the longest duration of the filler material. Experience in knowing the anatomy is critical, so a surgeon is the best person to consult

Brian Windle, MD (retired) · Answer

Without photos it is difficult to tell you what would be
best but almost always the problem is a deep tear trough, which gives the
appearance of bags under the eyes. 
Filler almost always will take care of this problem and the long term
filler, Bellafill works exceptionally well for this problem.  You need to be aware of the potential complications
of fillers but they are a great fix for a tear trough problem.

I have added a before and after web reference for you as well as a video on
filler safety.

I hope that helps.

Best regards.

Can Botox or fillers get rid of under eye bags?

Answers (10)

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