Do I need eye bag surgery or no? (photo)

Please let me know what you would recommend based on my photos. I just turned 31 and have these hideous eye bags that are driving me crazy. There is a wrinkle starting to form below bags from the way I sleep. Am I doomed with surgery or are there other options? How long do surgical results last? Ive recently developed the "11" between my eyebrows and I have one annoying forehead crease. I feel so ugly and helpless about all this and like I'm showing aging signs too young. I feel as if I look 40!

Doctor Answers 3

Filler over surgery: Cup half full or half empty

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Hi Christine.

The photo you posted on the left which shows a close up of your eyes is good one to look at.  Let's look at it together and it may make more sense why my colleagues are also thinking filler over surgery.  

If we examine the close up photo, we can see a dark line which goes diagonally across your cheek.  This line is called a tear trough.  If you look very closely at this dark line, you will see that it is a very small groove.  Above the tear trough we see a "highlighted" area which you are calling an eyebag. This eyebag is highlighted and appears to be bulging as a convex bulge.  If you have lower eyelid surgery, you will be pushing the bulge flat, but this will take the highlight away and make it go into the "darkness" and potentially cause a dark circle instead of a mini-eyebag

If you were using an Adobe Photoshop program, you would unlikely make the highlighted area darker, because then you would have dark circles instead of a mini-eyebag and tear trough groove.  Instead a Photoshop retoucher would more likely highlight the tear trough and blend it with the mini-eyebag and make the cheek appear to be continuous with the eyebag.  The top half of the eye bag would then become the top of your cheek and the bottom half of the eyebag would be blended across the tear trough to make your cheek seamless with your lower eyelids.

I hope that analogy makes sense.  Having said that, fillers do have a very small risk of infection, but with the type of temporary fillers that we use, this filler can be completely dissolved which would then resolve the infection.  In general the results of the temporary filler lasts around 12-18 months and when the patient returns for a touch up, they may only use  a fraction of the amount of filler that they used in the first session.

Click on the Web link to see a nice example of what fillers can do for a more severe eyebag than yours.

Good luck.

Dr. Yang

New York Facial Plastic Surgeon
4.8 out of 5 stars 33 reviews

Eye bag surgery or no?

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Hello and thank you for your question.
There are a couple of ways to address the issues with your lower eyelids. Fillers such as Restylane or fat grafting can be used to fill in the hollow below the bags, and this will help to camouflage the appearance of the bags. Although neither of these options addresses the bags themselves obviously. To be rid of them, that requires eyelid surgery where an incision is made inside the eyelid so it is never seen after surgery. .I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.
Best of luck to you!


Under eye hollowing

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You do have some early prolapsed orbital fat.  This can be improved by putting some filler into the tear trough.  As you age, you may get more fat at which point you can consider fat repositioning blepharoplasty.  For the forehead creases, Botox or dysport will work well.   

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