Follow up to question on best treatment for eye bags (Photo)

Several doctors wanted a better picture. Not sure this is better but thought I would post just in case
This is a follow-up to an earlier question. Click here to read it.

Doctor Answers 7

Follow up to question on best treatment for eye bags

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Hello SS2978,

As you can see there are a lot of opinions on the best treatment for eye bags based on the other responses.  You can continue to try to camouflage the area with makeup, you can use temporary fillers to help soften the shadow below your eyes (I like Restylane for the tear trough), or you can undergo a surgery.  There are pros and cons to each route.  I would recommend you consult with a facial plastic surgeon, plastic surgeon, or oculoplastic surgeon who also does his or her own injections.  This way you can get a good idea about the best treatment option for you.  If you go to a non surgeon or a surgeon who doesn't also inject then you will only get to hear what they offer.  

I hope this helps and good luck.  

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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The eyes are best treated with a combination approach of fillers, lasers, microneedling/PRP for improvement. Ultherapy/thermage, venus legacy all do well for swelling or puffiness. I would suggest consulting an expert. If surgery is an option they will recommend. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

You have options here.

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Fillers would work.  While they are temporary, it avoids surgery and lasts about a year or more.  The downside is you need someone who is truly great at placing filler and most injectors are not great.  Under eye surgery in the form of transconjunctival arcus marginalis surgery would move the eyelid fat into the top of the cheek.  This requires surgery to accomplish but provides long term help.  Finally this area would also respond to a chemical peel that firms the lower eyelid skin and will effectively level the eyelid fat.  I recommend finding a fellowship trained, aesthetically focused oculoplastic surgeon for this work.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Treatment for lower eye bags

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Thank you for sharing your question and photo. You probably would see some benefit with fillers, but even more with lower eyelid blepharoplasty. See an Oculoplastic Surgeon in person for evaluation and guidance.
Good luck,

Prominent orbital fat

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Hello. I reviewed both of your photos. You have relatively prominent eyes with prolapsed orbital fat. A modest benefit may be achieved with filler injections around your eyes. A lower eyelid blepharoplasty with repositioning of the prominent orbital fat would likely lead to the longest lasting and best results. I would be cautious with any surgeon who recommends fat removal, especially given the anatomy of your eyes and eye socket. I would recommend a personal evaluation with an ophthalmic plastic surgeon. 

Steven Couch, MD, FACS
Saint Louis Oculoplastic Surgeon


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Fillers alone likely will be disappointing. A thorough hands on evaluation is mandatory for expert advice and options. Non-surgical specialists will guide you away from surgery so it is wise to seek master surgeons who will give you, and can deliver, all the options.

Your photos suggest fat herniation without excess skin. This would make you a possible candidate for trans-conjunctival blepharoplasty. (removal of fat behind the eyelid). see video below

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 11 reviews

Fillers can help

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Fillers such as juvederm or restylane can help the depression below your lower eyelids and help you look more youthful.
Surgery will also help, but takes recovery and an OR.

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.