Which non surgical procedure would be best for minimizing the appearance of my eye bags? (photo)

Question

Preferably non-surgical. I live in England. Please help

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Mats Hagstrom, MD (license on probation) · Answer

Facial aging in the midface is a bit complex.
There are often two separate ideologies that are contributing.
In order to choose the best treatment option it’s to differentiate which one of these ideologies is Primary.
To start it helps if you have a good understanding of what the ideal aesthetics should be.
In a youthful face, the lower eyelid should be snug and tight.
Just below the upper part of the midface should be full and plump.
With typical aging the two areas reverse Toyota
People develop bulging in the lower eyelids with a loss of volume in the area just below.Can you case both of these ideologies are involved.
Restoration can be achieved using injectable, fillers, fat transfer, with facial implants or the use of a mid facelift. Of these well-done facial fillers are probably ideal, though they are temporary so many people are looking for a more permanent solution.
With permanence comes potential issues if patients are unhappy with the outcome of the surgical pro
To remove the bulging of the lower eyelids, typically fat from the three fat pads deep to the lower eyelid is often reduced. 
This is done with the procedure, called the lower eyelid blepharoplasty. The procedure can involve skin removal as well. 
Both approaches can be helpful and most likely the best results would be treating both ideologies, which would be two separate procedures potentially done at the same time.
This area is fairly complex and it’s not always easy to understand or treat.
For this reason different providers have different opinions guide
That is often the case when things are not straightforward or whenever there is no one single best solution.
Each treatment option has advantages and disadvantages, and there is no simple best treatment option.
In the end, provider selection is probably even more important than what procedure you select.
To find the right provider, I suggest having multiple in person consultations with the plastic surgeons, facial plastic surgeons, or oculoplastic surgeons in your community. (avoid virtual consultations whenever possible)
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 had similar facial characteristics to your own.
Bring a complete set of facial pictures to the consultation to use as reference, especially for the review of before and after pictures.
Don’t rely on memory or looking in the mirror to remember what you look like.
There’s no correct number of consultations needed to find the right provider.
The more consultations you have the more likely you are to find the better provider for your needs.
As I mentioned previously, this area is complex and not at all easy or straightforward to treat with consistent high-quality outcomes.
I recommend patients be more selective than they think necessary before considering any permanent irreversible treatment option.
Best,
Mats Hagstrom MD

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