Post parasite, low anemia/b12 and resulting eye bags age 30. Will they resolve naturally? (Photo)

It appears that you have fat from around the eyes protruding in the lower eyelid space. This often occurs with age and as discussed by another doctor before, can be related to fat changes in the cheek area as well.Although this usually appears in people after 40 years of age, I have seen it in younger individuals like yourself. You also appear to have a swollen mound on the cheek especially on your left side. This is called an eyelid festoon or malar mound. The best option for you once your medical condition is stabilized is to consult with an expert in Eyelid surgery such as an Oculoplastic surgeon. The best outcome would involve addressing both the lower eyelid fat and the festoons. Hope this was helpful.

Your eye bags are probably more the result of age than your parasite. Although poor health certainly doesn't help. Schedule a consultation with a board certified plastic surgeon in your area to discuss putting a bit of HA filler into your tear trough area to improve the overall look of your under eye area and get rid of your bags and dark circles.
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately. All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

I'm not sure about the gut infection and it's relation to the eye bags - it may just be a temporal relationship.  Your postnasal drip may be related however as it may indicate that you have an allergic component which can affect the under eye appearance.  It may be worth seeing if allergy treatment helps your under eye appearance. Give it some time - heal from your infection and optimize allergy treatment but you may benefit from lower eyelid blepharoplasty.  Good luck!

Your photos demonstrate a few different things that are contributing to your eye bags. These may or may not be related to your prior infection. You have a loss of fat in your cheek and area directly Under the lower lids. This hollowing is accentuating the puffiness that you see in the lid itself. I wonder if you had some weight loss with your infection. The puffiness may be related to inflammation in the nose or sinuses as well as from a prior infection. I would give your body some time to recover, then if still present discuss your options with an eyelid specialist. These can include in office treatments (Restylane, Juvederm Voluma) and/ or surgery (lower eyelid blepharoplasty). 

Thank you for your question. I understand you’re 30-years-old, and never had eye bags before. However, due to a parasite-related gut infection, you experienced iron, ferritin and B12 deficiencies, and developed eye bags during this time. You’re asking if the eye bags will resolve once you’ve addressed your nutritional deficiencies.Under eye bags is a common issue that we deal with in our practice, so I can give you some perspective on whether a systemic issue is relevant to the presence of under eye bags. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years.Noticeable bags that are present under the eyes, and push out a bit further when you look upwards, are caused by something called lower eye fat prolapse. This refers to the protrusion or bulging of the fat pockets that are normally situated around your eyes.Most of the time, eye bags are genetic that can be inherited from family members. In fact, I have operated on three generations of the same family for prominent eye bags. However, I think in your case, this may be lower eyelid fat prolapse.It is possible for a parasitic infection to accelerate the protrusion of lower eye bags, however there isn’t enough data to say this definitively. Rather, this is based more on anecdotes from patients—usually those who have severe sinusitis or chronic allergies will describe constant issues with drainage and puffy eyes.When it comes to medicine, temporal relationships are equated to causational relationships, which is a logical flaw. If two events related to your health or physical being happen, it doesn’t necessarily mean they are cause and effect.In our practice, we deal with lower eyelid fat prolapse non-surgically and surgically, depending on the severity of the eye bags. A non-surgical approach typically involves injectable fillers, such as Restylane, and platelet-rich plasma (PRP) to improve skin quality. A surgical approach is needed if the eye bags or fat pockets have prolapsed to the point where they cannot be camouflaged, involves a procedure called a lower eyelid blepharoplasty. This procedure is performed under local anaesthesia with LITE® intravenous sedation that allows the patient to remain in a twilight state of consciousness throughout the procedure, unlike general anaesthesia, wherein the patient is completely unconscious. We perform this in our own operating facilities in our clinics. The surgery itself usually takes about an hour. Results last quite a long time because fat pockets under the eyes cannot come back.It is important that the patient undergoing the procedure is healthy, so it is advisable that you first address your nutritional issues before undergoing any corrective surgery. After your iron and B12 levels return, allow about six months to a year to pass, and you’ll probably feel comfortable with the idea of doing something to intervene, as a physical change like this is likely not to get better on its own. In our practice, we document your case with some photos, then wait for your metabolic situation to be addressed and settle down. We then take another set of photos after a certain period of time, and compare the two. Clinical medicine, after all, is not just about performing procedures, but also involves a lot of observation and planning.I recommend you meet with experienced and qualified doctors and learn more about your options. I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.