Best surgical option to correct eye bags and dark circles? (Photo)

Question

I have had hereditary eye bags and dark circles as long as I remember. No amount of skincare or lifestyle changes help. What would be the best proceedure to get rid of these.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so you seem young to have eyebags, but I agree there is an element of that in you.

Many patients in their 30s and 40s need a mid facelift, but I think you can do without this additional surgery. Your options are therefore pinch blepharoplasty with fat resection, or lower eyelid surgery through a conjunctival incision.

Both are effective. My personal preference would be the first one as the skin can be made a little tighter at the same time.

I have a number of videos on this and other cosmetic surgery questions on my YouTube channel Adam goodwin surgery, if you'd like to learn more.

Best wishes, Adam, Goodwin.

Mats Hagstrom, MD (license on probation) · Answer

The lower eyelid mid face area is relatively complex and not always straightforward in regards to treatment options.
There are two typical changes we see in facial aging. I’ll first try to explain how we perceive a youthful face. In youthful appearance the contour of the lower eyelid, it should be tight and snug. Immediately below this, the area should be plump and full of volume as a transition into the upper part of the mid phase. With typical facial aging to changes begin to happen. The lower eyelid develop fullness from the bulging of the fat pads around the lower eyelid due to weakening of the Peri orbital septum. Immediately below this individuals begin to lose volume in the teardrop and upper part of the mid face. These few changes happen immediately adjacent to each other. A quality assessment. The first step should be to determine if the bulging of the fat pad is the primary problem or if the loss of volume immediately below this is the primary problem.
Removal of the fat pads of the lower eyelid generally called a lower eyelids. Blepharoplasty will treat the bulging fat pads. Volume restoration of the tear trough and upper mid face can be done using fillers, fat grafting, implants, or with a mid facelift.
Sometimes a combination of treating both conditions with slight caution can give optimal outcomes. If all the fat in the lower eyelid, fat pad is removed, it can create a hollow appearance at the same time, trying to correct the problem using only volume restoration may be slightly insufficient.
This type of work, both in regards to the assessment and treatment options has to be somewhat subjective and you may get different input from different providers, especially from those who don’t have all the tools in their toolbox. If you ask a nurse injector who only works with fillers, then they will tell you that fillers alone is the best option. An ocular plastic surgeon may tell you that a typical traditional lower eyelid. Blepharoplasty is the way to go.
The following are some general guidelines for finding the best provider. Following these guidelines is also a good way to get a good assessment and better understanding of treatment options.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Best surgical option to correct eye bags and dark circles? (Photo)

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