There are two main factors that contribute to the appearance of under eye bags, distribution of volume and skin and lid laxity. Believe it or not the major contributor in most people is volume redistribution that happens with aging. We all start loosing the high cheek and periorbital (around the eye) volume in our late teens and early twenties and and start really noticing in our thirties and fourties. When the volume around the eyes dissipates, it makes the lower lid deep fat visible ie lower lid bags. A modern blepharoplasty is very different from blepharoplasty done even one to two decades ago. In the past blepharoplasty involved removing and discarding fat from deep in the lower lid, but now we recognize the value of preserving it and transposing it to anew position that helps aesthetically. I usually treat patients like yourself who have these findings but are not ready for surgery with what I call "aesthetic facial balancing." What this means is I use volume in the form of Hyaluronic acid based fillers of your body's own fat to restore the volume and shapes of youth which again make the bags hidden. This also helps with the loose skin and ensures that you will have an even better result when and if you decide to have a formal blepharoplasty. Treating with HA fillers is a quick procedure with low downtime. Fat grafting can also be done under local but I usually put patients to sleep for this procedure and I would recommend having a blepharoplasty if you are going to sleep. I hope this helps!
All the best,
Rian A. Maercks M.D.
Thank you for your question. For non-surgical treatments, I recommend hydraulic acid fillers. I suggest that you consult in person with a board certified facial plastic surgeon.
Fillers, lasers, microneedling/PRP as well options for treatment in this area without surgery. I suggest seeing an expert. Best, Dr. Emer.
Thank you for your question and photos. I would suggest a lower lid blepharopalsty with laser skin resurfacing. This would greatly improve the appearance of your lower lids and give you a very natural look.
Thank you for sharing your question and posting your photos. The appearance of your eyelids could be enhanced with injection of Restylane and with laser skin resurfacing. See an eyelid expert for detailed evaluation and proper guidance. Good luck,