Upper blepharoplasty sufficient for drooping eyelids and injections for undereye bags? (photo)

I'm 29, and within the past 4-5 years my eyelids and under eye bags have gotten worse. Would an upper blepharoplasty be sufficient for my drooping eyelids? For the under eye bags, I've read perhaps injections may be the best remedy versus surgery given my age.

Doctor Answers 11


Thank you for your question. A blepharoplasty can remove the fatty deposits that can accumulate in the upper eyelid, and then tighten up the loose or sagging skin that starts to develop around the eye. I suggest that you move forward and consult with a board certified facial plastic surgeon. You will certainly benefit from an in-person examination. 

Best wishes,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Upper eyelid surgery with filler

You are correct that you have two options. One option is to undergo both a upper and lower blepharoplasty (under general or sedation anesthesia). The second is to do just an upper bleph with filler to the teat trough of the lower eyelid (under local or local with sedation anesthesia). The second option would certainly address the upper eyelid while temporarily address the lower eyelid. The recovery and expense would be less with this option and given your age- perhaps a better option.

Sandy Sule, MD
Dallas Facial Plastic Surgeon
4.3 out of 5 stars 13 reviews

Upper blepharoplasty and lower eyelid bags

Thank you for your question.  The issues that you are asking about are not due to 'age' per se, but rather an aspect of your genetics and anatomy.  Based on your picture, a conservative blepharoplasty can be performed to address the full upper eyelid tissue.  There is also evidence of lower eyelid bulging from fat.  Bulging lower eyelid fat can be addressed with removal of the fat through a lower eyelid blepharoplasty.  The bulging in the lower eyelids can sometimes be addressed with dermal fillers (such as restylane or juvederm) to help mask the 'bulge' and to create a more smooth contour between the lower eyelid and upper cheek.  Ultimately, an in person consultation with a specialist is required to determine the most appropriate treatment options for you.  Good luck. 

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Eyelid injections are not recommended

Injecting eyelids is always a bad idea.  Surgery is the only rationale way to fix eyelid issues regardless of patient age.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

29 year old upper eyelid droop

As a 29 year old, you'll want to proceed rather conservatively so as not to limit your future options - make sure you don't take too much upper or lower lid skin or fat. I might consider a mini temporal brow lift to lift the heaviness from your upper lid area, then you'd see great results with only a limited upper lid lift. As for the lower lids, again, I would want to be conservative about removing fat or skin. I would discuss an Intensif - radio-frequency micro needling treatment with PRP (platelet rich protein) to restore smoothness and structure to the under eye area.

David Hartman, MD, FACS
Canton Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Upper blepharoplasty sufficient for drooping eyelids and injections for undereye bags?

The fullness in  your upper eyelid appears to simply be excess skin and is certainly easily correctable with an upper eyelid blepharoplasty. It does not appear that you have excess fatty tissue in the upper eyelid. The puffiness in your lower eyelids is a result of fat pads bulging into the eyelid behind the muscle and orbital septum. Any kind of nasal congestion or excess fluid in your circulation can worsen this because the blood flow around your eyelid doesn't drain down the cheek, it drains into the central system via the nose. When the nose is stuffy or if you have too much salt in your diet, the puffiness will be worse. When there is excess fatty tissue present, the fat can be removed or repositioned to give you a more permanent correction without the need for fillers injected around the eye on a regular basis. The fillers are not without complications and are not generally recommended for your condition.

John Standefer MD

John A. Standefer Jr., MD, FACS
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 61 reviews

Eyelid rejuvenation

You are an excellent candidate for skin only upper eyelid surgery, which will really refreshen your appearance. The lower lids can be rejuvenated with filler such as Restylane or Belotero to camouflage the fatty bulge, and this is a great non-surgical option for you. Surgery to eliminate the fatty bulge under the eye is also an option for you, and you are an ideal candidate to have that addressed through the inside of your eyelid (transconjunctival) without any external scars. Seek out the consultation of a board certified facial plastic surgeon, plastic surgeon, or Occuloplastic surgeon. Check out my gallery link. Good luck!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 49 reviews

Upper blepharoplasty sufficient for drooping eyelids and injections for undereye bags?

You don't have droopy upper eyelids (ptosis) but rather some relatively excess skin which can be benefited from conservative skin only upper blepharoplasty. For under eye area, your options include either filler injection in the relative hollow area (dark circles) or more long-term option lower blepharoplasty with fat repositioning where the fat bags are repositioned to fill the hollow area below them. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Less is more.

Yes, under eye fillers in the form of Restylane is a fantastic alternative for you instead of surgery.  The upper eyelid will require a very sophisticated surgeon.  Less is more.  You need a very detailed structured microblepharoplasty.  The goal is definition.  You need a small amount of upper eyelid fold removed to expose the upper eyelid platform.  No fat should be removed and you need an anchor blepharoplasty to support the upper eyelid lashes.  In my opinion less than 0.01% of eyelid surgeons can deliver this type of work.  Look carefully for the right eyelid surgeon.

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

Upper blepharoplasty sufficient for drooping eyelids and injections for under eye bags

A conservative skin only  upper blepharoplasty can address removal of   hooded upper eyelid skin creating the tired look. In our practice, we do not recommend filler injections placed in the lower lids due to  numerous complications that can occur in that area. When patients have significant fatty deposits in the lower lids that are herniated outward creating the puffy look, a trans-conjunctival lower lid blepharoplasty is performed to rejuvenate the lower lids. This involves the incision placed only on the inside of the lower lid. For more information many  before-and-after examples, please see the link and video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 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.