Early 20s with Serious Eye Bags. Treatment Options?

Thank you for your question. There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

Your eyes appear puffy in large part because the area underneath them( the mid face), is hollow.  Building this area up with filler such as hyaluronic acid, possibly up to two cc's per side will help.

 The other option is an augmentation blepharoplasty, where the puffiness is removed from the inside of the eyelid, and fat which is removed from another part of the body is placed in the lower eyelid/upper cheek area(autologous fat transfer).

Hi 453756anon in CA,

Generally, there are a few options to improve the appearance of the lower eyelids, eye bags, or dark circles. First option includes basic skin care, tretinoin, and/or chemical peels. This nonsurgical method helps improve the skin quality, reduce pigmentary changes, and improves overall appearance of the lower eyelid & cheek areas.

Second more advanced option is an injectable filler or fat to plump up the area. Fillers are made of material that is slowly removed over time. Facial fillers treatment is performed in the office vial local anesthesia.

The last option, and also the most aggressive, is eyelid plastic surgery. Cosmetic surgery of the lower eyelid may remove or reposition fat in the eye bag area, and possible remove some sagging skin. Plastic surgeons typically don't recommend cosmetic eyelid surgery in young patients.

Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki

You have 2 options available-inject fillers or surgery. Fillers in this area have to injected carefully and you have to inject the right kind of filler to avoid lumps and other problems. Surgery involves suturing the eyelid fat to the deep cheek fat in order to raise the surface trough that currently exists between the cheek and lower eyelid. You can see an example of this in my patient photos on real self.

I see your concern, but your photo is too limited to determine what treatment would be best for you. Most patients your age benefit from a Filler treatment.  My personal preference and expertise is with Silikon-1000 for permanent results.

In general, I advise against lower eyelid fat removal in someone your age. You may end up with a hollow, operated appearance that could be difficult to correct.

I hope this is helpful for you.