Lower Blepharoplasty or InfraOrbital Rim Implants (photo)

Question

Hello everyone. I’m 18, and unfortunately I have bad under-eye bags. It’s genetic, and I’ve already tried every skincare method known, and nothing. I’m only 18, so it’s not the worst, but both my mom and grandma have it, and it’s only a matter of time before it gets worse. I was looking into these two surgical options. Which one would be better for me? I wouldn’t mind my eyes looking a little more striking, and I would love to somewhat fix my deep sunken eye bags. My eyes also get very droopy.

Zoran Potparic, MD · Answer

Unfortunately your photo does not show much of what is needed for good evaluation and advice; full face photos and profiles would help. Malar hypoplasia or small cheek bones is most likely underlying reason for your problem. Augmentation of the cheeks with implants and lower blepharoplasty would be a set of procedures to consider. In person consultation with a board certified plastic surgeon with good reputation in facial implants is recommended. Good luck.

Ruslan Zhuravsky, DO · Answer

Although skin care is important, it only helps with skin, not the fat pads or contours underneath. This photo is out of focus and it is hard to tell your anatomy. Younger patient with lower eyelid issues typically have a negative vector. This means the fat is pushing forward more and creating a "bag" because the bone of the lower orbital rim / cheek is recessed. So the entire eye comes out more than the bone. Cases like this can be approached with a variety of methods, depending on your specific anatomy and needs .... filler (done properly), fat grafting, fat transposition via lower blepharoplasty, or SOOF lift. I am not a fan of implants in the cheek, especially on someone so young ... this area changes a lot throughout your life and leads to movement of the implant .... I have also come across issues when preforming facelifts on patients with implants in this area. Do formal consults with several surgeons that specialize in facial and eyelid surgery. Don't just go the any plastic surgeon and assume they can do a good job. This is a very delicate area and the wrong surgery can be extreme difficult to fix. Good luck!

Nelson Lee Novick, MD · Answer

Unfortunately, the one photo provided does not allow for an adequate assessment of the problem and for evaluation of the surrounding tissues, which not uncommonly play a significant role in some under-eye issues.
What I can say is that, depending upon the specific problem(s), there are a number of nonsurgical options that can be quite helpful, including a series of in-office superficial peels for improving skin quality, color, and texture and tautness; Botox for shrinking under-eye "jelly rolls," and fillers for addressing under-eye hollows and tear troughs. In the hands of an experienced, expert, board certified cosmetic dermatologist, each of these can be performed in the course of one treatment sessions.
No doubt you are thinking that surgery or implants are a one-and-done. However, this is seldom true, especially for very young people. Why?  Because with the natural aging process there are inevitable changes in the underlying and surrounding skin, such as the loss of bone, muscle, fat and fibrous tissue. So, what may look fine right away after expensive, invasive surgery may no longer look good or natural five or ten years down the road (due to the surrounding and underlying aging changes) necessitating more surgeries or the removal of the implant and insertion of another (I.e. another surgery, as well).
Before diving into surgery, you would be wise to consult with an expert board certified cosmetic dermatologist. 
Hope this helps and saves you a whole lot of money, time, frustration and disappointment going forward. Best of luck..

Lower Blepharoplasty or InfraOrbital Rim Implants (photo)

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Lower Blepharoplasty or InfraOrbital Rim Implants (photo)

Answers (3)

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