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.
