32 year old male - what are my options to reduce the appearance of puffy eyes? (photos)

Lower eye bags are often seen in younger patients, usually as a hereditary cause. They are easily addressed with lower eyelid surgery through the conjunctiva so there is no scar on the skin. Sometimes fat is injected in the crease below the eye bag to make it appear smoother. Be sure to see a facial specialist for consultation.

Hello! Thank you for your question.As far as I can see from your photos you have extra skin under your eyes and dark circles. For get rid of the extra skin, make your under eye more bright, fresh and elegant I suggest lower eyelid blepharoplasty and fat injection to under your eye area. Best Regards!

Hi @Vic1990. Thank you for sending your photos-- you would be a great candidate for a transconjunctival lower blepharoplasty with fat transfer. A lower blepharoplasty will address the herniated fat pads and excess skin under your eyes giving you a more refreshed and rested appearance. Best of luck, Dr. Nima!

Thank you for your question and photos. It is possible to reduce the appearance of bags under the eyes with a lower blepharoplasty procedure. This surgical approach can smooth the transition between the eye and upper cheek by removing excess skin and sculpting, repositioning, or removing excess fat. By contouring and restructuring the lower lid, the eyes can appear more open, awake, and refreshed. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your concerns and aesthetic goals and determine the best approach.

You are a candidate for a transconjunctival lower eyelid blepharoplasty and micro fat grafting. This approach uses an incision on the inside of your lower lid so there is not an externally visible scar. Some surgeons market this as a "scarless" blepharoplasty. Lower eyelid blepharoplasty allows the surgeon to contour the lower lid fat (which contributes to lower lid bags) and release other structures that help form the bags. Micro fat grafting uses your own fat (harvested with liposuction) to precisely fill in the tear trough and cheeks to create a smooth transition from lid to cheek. You may also benefit from skin resurfacing to tighten your lower lids (fractionated CO2 laser or chemical peel).

Common reasons for lower blepharoplasty include tear trough deformity or pseudoherniation of the orbital fat. An in-person exam would provide a more accurate diagnosis, but preliminarily based on your photos it does appear you have pseudoherniation of fat creating "eye bags.” They should also be more prominent when you look up. Transconjunctival lower blepharoplasty with fat repositioning will provide nice results and a better lid-cheek transition in this case. Do your due diligence, find an experienced surgeon, and have him/her evaluate you in person and discuss your options. @drdonyoo

There are a couple of options you could use to improve the puffiness under your eyes. Lower eyelid surgery could be done to address the protruding fat directly. Another option would be using an injectable filler under the puffiness to help blend and camouflage the fullness. Surgery would normally give a very long lasting result, while the filler could last about a year or so.

I think you would be a good candidate for a lower lid blepharoplasty with fat transposition. This would taken the “eyelid bag” and move it to fill the tear trough. Best to see an eyelid expert in your area.

For puffiness and sagging under the eyes, we often use Renuvion helium plasma radiofrequency energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Eyelid Lift.' The focused heating tightens and peels the upper layers of skin with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​ See an expert to determine if this is the best solution for you. Best, Dr. Emer

First of all you could try a low salt diet to see if that helps with the puffiness in your lower lids. The photographs demonstrate herniated fat pads in the lower lids which usually requires a lower blepharoplasty procedure to improve. A trans conjunctival approach lower eyelid surgery can accomplish removal of those bags with two small incisions on the inside of each eyelid. No external incisions are required. The Procedure is performed under a brief general anesthesia as an outpatient procedure.