What is the best treatment option for my under eyes? 32 y/o (photos)

Question

Hello! I am a 33 year old black female (does being black change anything?) I have plum skin, I'm usually mistaken for a teenager (not complaining) BUT I've had puffy looking eye bags my whole life with lines extending to the outer mid face. I have had enough I can't stand it anymore. I'm convinced I need a lower blepharoplasty? Is this my only option or could endolift or filler or someone other resurfacing treatment be considered?

Jeffrey H. Spiegel, MD · Answer

I would move fat from the lower lid into the hollow area beneath your eyelid. This would help reduce the puffiness. The entire thing is a quick outpatient procedure and could be done through the inside of your eyelids (no external incisions or stitches).  Filler could help in the short term though.

Thomas Buonassisi, MD · Answer

Your skin's natural plumpness and youthful appearance can definitely be an asset, but I understand how persistent puffy eye bags and lines can be frustrating. While lower blepharoplasty is a common solution for addressing these concerns, there are also non-surgical options to consider. Treatments like fillers can are most effective at restoring volume in the mid-face, while treatments like endolift offers a minimally invasive way to tighten the skin. Additionally, resurfacing treatments like laser therapy or chemical peels can improve overall skin texture and elasticity. It’s important to consult with a qualified professional who can evaluate your specific needs and recommend the best approach tailored to your skin type and concerns.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

From the photos, there appears to be significant volume deficit in the upper cheek region accounting in large part for the bags and tear troughs seen (since the upper cheek region is a major support for the under-eyes). An appropriate volumizing filler properly injected into the upper cheek region will not only create a more youthful mid-face, but also diminish the infraorbital bags and tear troughs and even likely improve somewhat the deep smile lines below. You would be wise to consult with a board certified cosmetic dermatologist and best of luck.

Randal Haworth, MD, FACS · Answer

Based on your pictures, the only way to definitely and effectively treat this issue is through a lower blepharoplasty - which would remove excess skin and, where necessary, pockets of fat.

I hope this helps,
best of luck in your journey !

What is the best treatment option for my under eyes? 32 y/o (photos)

Answers (6)

Answer: An HA Volumizing Filler For The Upper Cheeks Can Diminish Under-Eye Bags & Tear Troughs

Answer: An HA Volumizing Filler For The Upper Cheeks Can Diminish Under-Eye Bags & Tear Troughs

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

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What is the best treatment option for my under eyes? 32 y/o (photos)

Answers (6)

Answer: An HA Volumizing Filler For The Upper Cheeks Can Diminish Under-Eye Bags & Tear Troughs

Answer: An HA Volumizing Filler For The Upper Cheeks Can Diminish Under-Eye Bags & Tear Troughs

Answer: Lower blepharoplasty

Answer: Lower blepharoplasty

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.