What's the best treatment for under eye bags? (Photo)

I am torn on what to do about my under eye puffiness. Would you recommend a surgical or non surgical approach? Is there any benefit to waiting until I'm older if surgery is needed? I've tried to attach a good photo that shows the puffiness at its worst.

Doctor Answers 14

Eyelid bags

Hello there, it appears that you have prominent lower eyelid fat pockets, which give the look of "eye bags." You will most likely benefit from a lower lid blepharoplasty surgery.  Fillers alone will not be helpful in your case. I recommend you seeking a consult with an eyelid expert.  Best of luck!

What's the best treatment for under eye bags?

Hello SS2978,
Thanks for your question.
A surgical blepharoplasty is the best long-term option for reducing the puffiness you see in your lower lids. There are risks that you must be comfortable with before you entertain surgery.
The most common nonsurgical option for your current situation would be to use injectable filler to temporarily camouflage the puffy areas in your lower lids.  This option is very much operator dependent. 
I would recommend that you consult with a board-certified plastic surgeon with extensive experience in eyelid rejuvenation to discuss both sets of options so that you can make the best decision for yourself.
Good luck,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

What's the best treatment for under eye bags?

Blepharoplasty surgery is the best, permanent solution. Fillers such as Belotero or Restylane can be used to camouflage the under eye bags, however. Fillers only require a brief in office procedure and the results typically last 9-12 months. My typical recommendation for someone with your type of undereye concerns would be blepharoplasty but fillers are a nice temporizing measure. If you do choose surgery, be wary if your surgeon also recommends removing skin from the undereye area. This could aggravate your eyelid position and create dry eye and/ or rounding of your lower eyelids. Best.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Surgery is the only way to get rid of eyelid bags

There are no non surgical options for eyelid bags that actually work. You need blepheroplasty, which is a surgical undertaking. It can be done at age of your choosing. 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Lower lid bags

You have some prolapsed fat but in this picture it doesn't seem too bad.  You would do well with an HA filler such as Restylane into the lower lid.  This usually lasts for at least one year.  You could also do a surgery with repositioning of the fat into the tear trough.  Should do well with either one.      

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Eye puffiness

Thank you for the photo. You do no need to jump into surgical treatments if you do not feel comfortable or if you are unsure. A quick and simple improvement can be achieved with hyaluronic acid fillers such as Restylane to your lower eyelid area to smooth and lighten the shadows in the area. Fillers are temporary however. For more permanent and dramatic results, the fat will need to be removed or repositioned and any extra skin will need to be removed through a blepharoplasty if necessary. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!

Johnson C. Lee MD
Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Lower eyelid bag treatment options

The good news is, there are excellent options for both surgical and nonsurgical treatment of lower eyelid bags. What is going to be best for you is dependent on your individual anatomy, goals, and needs.

Nonsurgical options are going to revolve around adding volume with fillers. This can give excellent results in the proper hands. Surgical approaches have evolved to be relatively minimally invasive, and also have excellent results and long-term outcomes.

To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut
#realself500 Physician

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 78 reviews

Surgical vs Nonsurgical

The surgical option, a lower blepharoplasty will offer long term results by treating the bags themselves while injectable fillers may improve the area by camouflaging the bags. I would recommend to see an experienced physician for an in person exam to determine the ideal treatment route based on your goals and candidacy.

Dr. Kathleen Morno

Kathleen Morno, MD
Highland Park Physician
5.0 out of 5 stars 1 review

Fillers or Surgery?

Thank you for sharing your question. Blepharoplasty would certainly treat your bags, however; injection of Restylane could work well too. See an experienced Oculoplastic Surgeon for evaluation and proper guidance for your specific eyelids.
Good luck,

Under eye bags

There is no right answer when choosing a non-surgical vs a surgical approach, it depends on what approach best fits your needs and desires. For under eye bags, the best non-surgical approach would be dermal fillers. The fillers that are generally used are not permanent and last anywhere between 6 months to a year, meaning, you would need multiple treatments to maintain the same result in the future. The surgical approach is called a lower eyelid blepharoplasty with fat removal. Some surgeons reposition the fat to prevent the under eyes from looking too hollow after the procedure. The surgical approach is a more permanent approach, however both non-surgical and surgical options can give you excellent results.

Maryam Nazemzadeh, MD
McLean Oculoplastic Surgeon
5.0 out of 5 stars 2 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.