I'm 24 years old and suffer from under-eye puffiness. Candidate For Transconjunctival Blepharoplasty or Restylane Filler?

Candidate For Transconjunctival Blepharoplasty or Restylane Filler? I am 24 years old and suffer from under-eye puffiness. I'm in dire need to correct this situation in order to restore my youth and happiness and not hide behind my glasses as I've been doing for years. Am I candidate for the less evasive Restylane filler? Or would you recommend full Transconjunctival Blepharoplasty? or im to young for this ?

Doctor Answers 13

Candidate for lower blepharoplasty or Juvederm fillers?

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I do both and here are the differences, IMHO.  From the photos, you do have fat bags of the lower eyelids.

  1. Blepharoplasty or eyelid surgery will decrease the volume of fat bags.  Typically this is permanent and done once.
  2. Fillers like Restylane or Juvederm will soften the lower edges of these fat bags but will not reduce the volume.  In fact, fillers add volume, not reduce them.  Fillers are temporary, must be repeated and because of the many vessels in this area and thin skin can create bruising and/or lumpiness.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Puffy Eyelids may benefit from surgery at an early age

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I myself underwent transconjucntival blepharoplasty at age 30 after considering it for several years prior. A weak orbital septum tends to run in families and will give you the bags under your eyes that are nicely highlighted by your photos. I'm sure your tired of people say you look tired, so I wouldn't hesitate to get a transconjucntival blepharoplasty done by a well qualified surgeon. A note about filler in the tear troughs, I feel that this procedure is overdone as a substitute for patients like yourself who really need a bleph. These patients just tend to have even more puffy eyelids after filler.  Wait at least 3 months after surgery for swelling to go down before considering filler.

Edmund Fisher, MD
Bakersfield Facial Plastic Surgeon
4.6 out of 5 stars 13 reviews

Blepharoplasty or filler

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These are nice photos and while you are younger than most who consider lower eyelid rejuvination, I would opt for conservative transconjunctival fat removal.  Good luck.

Gary Lelli, Jr., MD
New York Oculoplastic Surgeon

Candidate For Transconjunctival Blepharoplasty or Restylane Filler?

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Great series of posted photos, thanks. My choice is transsconj bleph. with a possible filler after 1 month healing. 

Transconjunctival will help but not 100%

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You did not include  lateral picture,but I would suggest that you have negative vector . You have sclera show .These finding indicate lack of check support and that is the reason for noticeable fatty pockets under the eye. Removal of the fat will help ,but you will have circles under the eyes post surgery. I would suggest adding fat grafting at the same time or later. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Filler or Blepharoplasty for puffy eyelids.

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You have a fairly common problem that we see in young individuals who inherit a tendancy for early puffiness of the lower eyelids.  This is fat that is bulging out due to a weak orbital septum.  In cases like yours, a conservative transconjunctival blepharoplasty should correct the problem.  In some cases, a prominent tear trough deformity also exists and this may require fat or filler injections to help camouflage this depression.  In your case the tear trough or transition zone from the thin eyelid skin to the thick cheek skin is not deep and should be fine after blepharoplasty.  Best of luck. 

Gregory Branham, MD
Saint Louis Facial Plastic Surgeon

Blepharoplasty or Filler

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This is a good questions and is answered in the context of your age and appearance.  This answer will not apply to all ages and faces.  Fillers do a great job with older individuals that have tissue loss or depression in the area o the lower eye lid.  A filler will help to camouflage or reduce the appearance of the bulging fat.  Younger individuals like yourself do not need more filling so the best result would be a careful removal of fat with a transconjunctival blepharoplasty.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Transconjunctival blepharoplasty for eyelid bags.

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Transconjunctival blepharoplasty for eyelid bags is what would be best since you have large bags and would make these larger with filler.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Candidate For Transconjunctival Blepharoplasty or Restylane Filler?

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These are excellent photos and truly show that you are a patient who has a genetic predisposition to have early pseudoherniation of fat in the lower eyelids.  Although, you could have filler to camoflauge the fullness a little bit...it would generate a very full eyelid overall.  I would say that a conservative transconjunctival blepharoplasty is very reasonable in your situation and would correct this problem entirely.  Based on your youthful age, healing from this procedure would be relatively rapid (10-14 days) and there would be no excess skin laxity as a concern.  I feel you would respond well to this option. 

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Tear trough improvement options

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You are actually a good candidate for several procedures.  Certainly injections with Restylane to the tear trough area will improve things.  If you are looking for a long term solution, you may want to consider a transconjunctival approach to some fat removal with the addition of fat injections to the tear trough region.  Another solution would be fat repositioning of the protruding fat in lower eyelids over the orbital rim, this would also improve the tear trough depression.

Jenifer L. Henderson, MD
Silverdale Facial Plastic Surgeon

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.