23 YO, Hereditary Eye Bags, Blepheroplasty or Filler? (Photos)

I've been cursed with my dad's under eye bags. I'd rather try a filler before surgery; would fillers make any difference in my case, or should I just do a blepheroplasty? I'm concerned about the results of both: 1) surgery: I don't want to have a disproportionate face due to my big cheeks (see selfies) 2) fillers: when I get tired/allergies act up and make my bags protrude even more, would the filler still have a good effect, or will I just be overly poofy? *Selfies have edited eye bags out*

Doctor Answers 8

Eyelid bags

It appears to be fat prolapse of the middle and nasal fat pads of the lower eyelids. I would conservatively remove fat from a trans- conjunctival approach. Draping the fat over the tear trough would help with the hollow area. Just removing the fat alone would give you the result the edited selfies show, as you notice there is some hollowness present but I think it looks good and this is an easier procedure to perform.


Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Volume versus surgery

Based on the photos provided, it appears that some of the fat around your eye is prominent, thus giving you a "puffy", tired look to your eyes. However, you also are lacking volume in the tear trough area, making the puffiness around your lower eyelids appear worse. If I were you,  I would first add volume to the tear trough area. This will likely improve the contour between your eyes and cheeks, making your eyes less "tired".

Sandy Sule, MD
Dallas Facial Plastic Surgeon
4.3 out of 5 stars 12 reviews

Lower eyelid blepharoplasty trans- conjunctival approach for eye bag removal

   The  photographs  demonstrate herniated fat pad in the lower lids, for which lower eyelid surgery can accomplish removal through a trans--conjunctival approach lower blepharoplasty procedure.  A conservative fat removal can accomplish improvement.  In our practice, we do not  recommend  placement of fillers around the eyelids for a variety of reasons.  For  more information and many before and after results of lower blepharoplasty, please see the link and video below 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Hereditary Eye Bags in the Young

What you have is very common and is due to how the elevator labii superioris muscle, the orbicularis muscle and the orbital septum attach. It is not excess fat. Therefore, most blepharoplasty techniques will not solve the problem. A surgeon who is a true expert in this area could, however, correct it. By far, the easiest way to correct the area is with a filler like Juvederm Voluma. This, too, requires an expert injector of the area. Therefore, choose wisely. (See ExpertInjector.org and PlasticSurgeryToday.com/non-surgical/todays-liquid-lift-wrinkle-and-contour-correction/)

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Lower eyelid bags

 Thank you for your question. Regarding the fullness in the lower eyelids, I would say that this is probably due to fat.  An exam would need to confirm this. However fillers may mask the fullness of the eyelid, but are not long term. For younger women such as yourself, I sometimes prefer lower eyelid blepharoplasty. In this procedure fat could be removed from the inside of the eyelid, without creating a scar. Your skin tone is good so the results should be a smooth looking lower eyelid. Good luck!

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 14 reviews

23 YO, Hereditary Eye Bags, Blepheroplasty or Filler?

You have both options: 1) lower blepharoplasty; 2) filler injection.  Lower blepharoplasty (transconjunctival with fat repositioning) will give long term results.  Filler injection is also effective but short term. Also, have to be careful not to inject too much filler since it can look puffy. See following link. See an oculoplastic specialist.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 63 reviews

What you need is a fussy service.

Who does your filler and how they do it makes all the difference.  Without examining you, it is impossible to know if the bag is due to herniate orbital fat or your orbital rim.  Put your finger on the bag.  If it feels hard, it is your orbital rim and lower eyelid surgery is not going to fix it.  However, these respond fabulously to under eye fillers.  You need a very experienced injector to get the best possible service.  This is not a treatment to get from a spa.  You are asking for someone to sculpt you.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Lower eyelid bags

Fillers may create a temporary imrovment in lower eyelid bags by camouflaging the bag. The negative of this is that fillers are temporary and that they don't alway optimally correct the anatomy.

Surgical correction (lower eyelid blepharoplasty ) is a more defined and long-lasting and sometimes permanent  correction of this problem . Seeks out a consultation with a board -certified plastic surgeon .

Michael H. Wojtanowski, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 5 reviews

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.