Hollows? Bags? What are these exactly? What filler is best? Or should I just get blepharoplasty? (photo)

I'm 45 and have had these all my life. They are genetic from my father's side. I'm ready to get rid of them for good, but honestly don't know the best course (filler or surgery). I can afford filler now, but can wait 3 or 4 months and afford surgery if that's a better option in the long run. But if I opt for surgery, I really want to know they will be gone for good.

Doctor Answers 2

Blepharoplasty Not Fillers Will Correct Hollow Eyes and Eye Bags

Thank you for your question. A combination of protruding eyelid fat and skin aging is causing the depression beneath your lower eyelid and the hollow appearance. The definitive procedure to correct this problem is a trans-conjunctival blepharoplasty with arcus release and fat grafting described in the link below.

Using fillers like Restylane in the lower eyelid does not solve the problem, is a camouflage technique, and there are many potential complications including visible gray lumps beneath the eyelid skin. I recommend that you search the Internet for complications following filler injections around the eyelids and my guess is this will dissuade you from considering injections. I also am concerned about repeated injections through the delicate thin eyelid skin over many years.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery or the American Board of Ophthalmology who has specialized training an oculoplastic surgical techniques.

Fillers are good temporarly solution.

The filler will help to fill in the tear trough and decrease the appearance of the prolapsed orbital fat. A more permanent solution would be to reposition the fat, whereby it is moved down into the tear trough. This creates a smoother transition from cheek into the eyelid. You also have a fair amount of wrinkling of the skin in this area. So I would recommend some laser resurfacing at the same time to try and improve the skin texture.

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

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.