Fillers or lower blepharoplasty?

Stone, Fillers are generally used when there is minimal fat protrusion, but there is a deeper tear trough (the groove under your eyelids).  Blepharoplasty procedures are recommended when there is a significant amount of fat protrusion, regardless of tear trough depth.  Without a picture, however, it is difficult to suggest a course of action.  Hope this helps.Cheers,Hugo

At 37, you may be a great candidate for filler. It is much more difficult to make older patients look great with lower eyelid filler. It just seems to work better in younger patients. However, it is temporary, so if you have the anatomy that would benefit from a lower blepharoplasty, you may want to consider one since it's a much longer lasting solution.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

While you are a little younger than most blepharoplasty patients, without seeing photos or meeting you in person, I cannot answer your question definitively. Fillers can be a nice “try-out” of a surgical procedure you may be considering. They also may be sufficient in your case to remedy your lower eye bags – particularly if they are really more “trough”-like than baggy. In the hands of an expert facial plastic surgeon, the hyaluronic acid fillers such as Juvederm and Belotero will not direct more attention to your lower eyes. Instead, they will rejuvenate the area so that the focus is once more on your eyes, where it should be.
However, the fact that you are describing eye “bags” – which suggests excess fat and skin underneath the eyes – leads me to lean more toward blepharoplasty. If you truly have eye bags, surgery is what will make the most dramatic and longest-lasting difference. A lower blepharoplasty would actually remove the excess fat and skin, plus tighten the skin under the eyes. Age is not a consideration; need is. The ultimate decision is yours. I hope this helps.

Lower eyelid bags can be treated by fillers or surgery. Both are correct. Which is best requires a personal exam. We need to see how far the bags protrude and if you have a deep tear trough. If done on the right person, fillers can look great and stave off surgery for years. However surgery is most often the best answer.

Thank you for your question. It is not possible to advise you without quality photos. In general someone as young as you will benefit greatly from gentle filler injections such as Restylane Silk or similar. Sometimes a skin resurfacing treatment provides a great deal of improvement while being much less invasive than a blepharopalsty. You should find a surgeon you trust who offers a full range of options. Together you can make an informed decision. Good luck!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  In patients with lower eye compartment fat herniation, lower eyelid blepharoplasty is a better option.  For minor tear troughs, fillers may be an option.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The answer depends on exactly how much bags/fat you have in relation to hollowness. Age should not be a factor. Lower blepharoplasty is best done through transconjunctival approach and the fat/bags should be repositioned to fill the hollow part below the bags. See following surgical video (graphic) and website link for more information.

Lower eyelid blepharoplasty is a better option even at a younger age. Fillers are temporary, do not fix the underlying problem and do carry certain risks. RegardsDr. J

Thank you for your question.
In the absence of a physical exam it is difficult to say with any certainty whether you are a better candidate for a lower lid blepharoplasty or cosmetic dermal fillers at the present time and I believe that your candidacy for either procedure should be based upon the physical presentation and anatomy of the lower lids rather than your age.
A lower lid blepharoplasty is a surgical procedure that addresses the herniation of the fat pockets of the lower lids that has caused this swollen bags appearance.  It can be approached either via a transconjuctival incision (no visible scarring) or a subciliary incision (at the lower lid lash line) depending upon whether or not there is excess skin that requires removal.  In many young patients, a lower blepharoplasty can be performed via a transconjuctival incision and affords patients a permanent fix to this problem.
The use of cosmetic dermal fillers, specifically Restylane, is another temporary option for patients looking to camouflage the 'puffiness' of the lower lids.  It works best for patients with very minor herniation of these fat pockets, but I caution patients that it is only a temporary solution and one that often requires multiple treatments (2+) annually to maintain.  The important thing to remember is that fillers are doing nothing to address the herniation of the fat pockets.  The fat will still be present until surgically removed and the fillers are being used to essentially fill up the depression below these fat pockets.
I hope you find this helpful and I wish you all of the best. 

It really depends on your anatomy more than your age.  Fillers can work quite well for patients with minimal fat herniation, a deep tear trough, and/or hollows underneath the eyes.   In patients with extensive fat herniation lower blepharoplasty is a much better treatment.