Which do I choose? 1 surgeon said I needed a lower and upper bleph, 1 recommended 1 vial of Voluma for both eyes around the upper cheeks and some diluted with water around the eyes, ocular guy said they weren't bad but if he performed surgery he would do a lower transcon bleph and remove all 3 fat pads. Is that conservative? What is the aggressive type of the past? I asked about the arcus marginalis release and he said it wasn't predictable and you can sometimes end up lumpy. I don't want to look worse or hollow.
I've had 3 consultations (2 plastic and one ocular plastic surgeon) for under eye bags with three opinions. (photos)
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Doctor Answers 9
Differences in Opinions on Lower Bleph
Your experience is not uncommon. It highlights that there is no absolute way to do things, and that the "best" procedure is the procedure that works best in each surgeon's hands. To help yourself, ask for photo examples of patients that may be similar to you that have been handled by each surgeon in their practice. Personally, I like the transconjunctival approach with a possible skin pinch based on your presentation in the photos. Again, there is generally no "best"...just what works well in one's hands. Best of luck.
You need upper and lower blepharoplasty
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Based on your photos I would recommend transconjunctival lower blepharoplasty to remove the extra fatty tissue under your eyes.I do not think releasing the arcus marginalis adds much to the procedure but other doctors will disagree with this. I will sometimes add filler to help blend the eyelid-cheek junction 6-8 weeks after surgery to optimize the results. I find filler injections are a lot more predictable than fat grafting or repositioning.
If you were not interested in surgery, adding volume to your upper cheeks (below the bags) can help camoflage the extra fatty tissue, but the results would not be as good as surgery. If you are looking for a little improvement, filler injections alone could be an option, but removing the extra fat would give you the best results.
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.