Eye bags only present when I smile. Would dermal fillers help minimize their appearance? 51 y/o (photos)

Thank you for submitting your question and photos. You may benefit from a liquid eye lift to reduce the appearance of the under-eye bags you’re referring to. Liquid eye lifts use dermal fillers to subtly replenish lost volume in this area, creating a smoother and brighter appearance.
The results from this filler treatment can last for up to 6-12 months or more, depending on the formula used. I recommend scheduling an in-person consultation with an experienced, board-certified injector. They will be able to suggest the best approach to address your concern and help you achieve your aesthetic goals.

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.

To answer your question about lower lid bags when you smile. There are a few reasons for lower lid bags: fluid, fat, or fullness. An evaluation with your oculofacial plastic surgeon can help determine which is the most prominent in your individual situation. When the bags appear only when smiling and not at rest it is generally more of a lower lid fullness, sometimes called "jelly rolls" of the lower lid. This appearance is generally improved with botox injections to relax the overactive orbicularis oculi muscle of the lower lid that activates when smiling. The effect of botox helps soften the bags and squinting appearance and gives your eye a more open, "disney-princess" look. Every person is different and your surgeon can help determine the appropriate course of treatment for you.