Under Eye Bags Treatment in San Jose

Hello, I've had under eye bags since I was a child. I felt that I would wake up with under eye bags from too much sleep or when I had too much alcohol (as a young adult). As I am getting older I am noticing that I have them every day and they are getting worse day by day. I am very insecure about them and wear non perscription glasses just to cover the bags with the frames of the glasses. I am 32 years old and feel I am too young to have surgery to remove them. I have a couple of questions. What is the best treatment for me? I have attached a photo for you to review the condition and to offer some advice on what's the best method to get rid of the under eye bags. If I were to get the surgery, how long would it last? How long do some of the other methods last? ARe there any type of facials that would help? Also, I just moved to the San Jose area. Do you have any recommendations who I could consult with?

Doctor Answers 5

Treatment of Under Eye Bags

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Thanks for the interesting question. Under eye bags can be quite common in younger patients. I have seen numerous patients in their late 20's and early 30's who have a genetic predisposition towards bags under the eyes. The most common complaint is that they are told by friends and family that they look "tired all the time". 

There are essentially two good options for you. The first is a lower blepharoplasty (lower eyelid surgery) with fat repositioning. The surgery is performed with small incisions made inside the lower eyelid, such that there are no external scars. This surgery involves moving the fat bags which are protruding in your lower eyelid area downward to fill the "tear troughs" and soften the transition between your lower eyelids and cheeks. Rather than removing the fat and hollowing the lower eyelid, my preference is to secure it underneath the thicker skin of the cheek, restoring volume to this area. The surgery takes approximately one and a half hours and is done on an outpatient basis. Most patients take around 8 to 10 days out of their work or social schedule. The duration of the results is hard to quantify precisely but the lower eyelids should look better for years and years to come.  A good way of thinking about it is that you would always look better than if you had not done the surgery. 

The second option is to use an injectable such as Restylane under the eyes. By placing a dermal filler underneath the bags, the appearance of these bags can be softened. The principle is the same as the lower eyelid surgery, in that you desire to restore a normal contour between the lower eyelid and cheek. The difference is that the lower eyelid fat pads remain in place but they appear less prominent by camouflaging the lower edges. Restylane injections in this area have previously been thought to last for 9 to 12 months but a recent study has shown effects lasting up to 2 years. The treatments are quite comfortable and take 15 to 20 minutes in the office. I strongly caution patients to stay away from any permanent fillers under the eyelids, as the skin is very thin and unforgiving in this area. Of the temporary fillers, Restylane is the best choice, in my opinion. The advantages of Restylane are that it is a smooth, clear filler and that it can be easily dissolved in the unlikely event that there are any lumps.

Facials would not improve the appearance of these bags to the extent that you would like. For patients with fine lines and wrinkles under the eyes, resurfacing techniques such as laser treatments and chemical peels can be effective. Some under eye skin products are good for these fine lines as well. For moderate to severe bags, surgery or fillers are going to be your best options. In the setting of a consultation, you could learn more about both surgery and dermal fillers and the surgeon could advise you about which would be best for your individual anatomy and aesthetic desires. 

Best regards,

Dr. Mehta

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Lower eyelid fat bags

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Yes, from the photos, it appears that you have excess fat bags in the medial and central compartments of the lower eyelids.  A transconjunctival lower eyelid surgery (blepharoplasty) will remove this excess fat in about 30 minutes.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Eyelid bags and San Jose and treatment

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Dear Sylmar, I am a board certifiied plastic surgeon in San Jose who routinely performs eyelid surgery - blepharoplasty.  In looking at your photos, I believe you would benefit from eyelid surgery.  Other non-surgeical treatments may help to a small extent,  but not nearly as much as the blepharoplasty.  For a free consultation, please call my office at (408) 356-4241.  

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Treatment of eyelid bags

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I do not think 32 is too young to undergo surgery. The patient in the bottom photo of the referenced blog was the same age. My preferred approach is to suture the bulging eyelid fat to the deeper cheek fat to soften the cheek eyelid junction and remove the crease you see at the junction. From just the photo you posted one cannot say if you are a candidate for that procedure. If the bulging fat retrudes when you look down you are not a good candidate for that procedure and other methods may be a better choice. No cosmetic surgery is permanent as you are always aging. The life span of any given cosmetic surgery is dependent on a number of factors including genetics, patient lifestyle, exposure to extreme climates, smoking etc. It is different for each individual patient.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Options to treat Bags Under Eyes

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When we look up, the fat prolapse in the lower lids worsens.  This photo probably makes your lower lids look worse than they normally would, because you have your head tilted down and your eyes are looking up.  I think you would benefit from finging an eyelid specialist in your area.  You can search for  a memeber of the American Society of Ophthalmic Plastic and Reconstructive Surgery.  Without examining you, it is difficult to make a recommendation, but you would likely benefit from either a lower blepharoplasty or from filler injection into your lower lids.

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.