Hi mira19. Thanks for your question. An in person consultation is necessary for determining what treatment is best for you. Based on the photos, it appears that you have significant hollowing of the cheek region and may benefit from fillers to the tear trough and cheek instead of surgery. This will fill the hollowing and eliminate the shadowing that you see. Fillers under the eyes typically last 1 year and are reversible. There is little risk to under eye fillers. Good luck, Best Dr H
Although bags under the lower eyelids are often associated with aging and tends to occur when we are in our 40s, 50s, 60s and beyond, sometimes they occur throughout life including childhood. Options may include a lower eyelid blepharoplasty, or the use of fillers to camouflage them. Fillers can be either natural, that is your own fat injected, or synthetic fillers such as hyaluronic gel's. Sometimes a combination of surgery and fillers yields the best result. During consultation, discuss different techniques if you are considering surgery. It is possible if you are young that you may be a good candidate for what is called a transconjunctival approach which may suit you better.
Thank you for a great question and for sharing your concern and photos. Bags under the eyes can be genetic and even occur in young people such as yourself. Excess fat can be removed from the lower eyelid without an external incision in these situations. It could also be camouflaged with fat grafting or fillers if mid face flattening and hollowing is a contributing factor. I hope you find this helpful. Best wishes!
Consult with a Board Certified Fellowship Trained Facial Plastic Surgery Specialist.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
I would suggest a non surgical approach with volumizing agents to improve the eyelid-cheek junction and flat midface. Even if you decide to go ahead with a lower blepharoplasty (augmenting transconjuctival), you will still require volumizing of the mid-face with hyaluronic acid fillers.
From the photos you submitted, it seems that a surgical approach would be the best both cosmetic and long term approach. A tranconjuctival approach has very minimal incisions with great outcomes.
Thank you for your question. There are both surgical options and non-surgical approaches to help you address you concerns.
1) Surgical - consider a transconjunctival lower blepharoplasty (lower lid surgery) to reposition the fatty tissue to the area immediately below it to soften the transition from the lid to the cheek. The main advantage of this is that it would provide the more definitive and long lasting procedure. In the long-run, this will also be your more cost-effective procedure.
2) Non-surgical - consider dermal fillers such as Restylane to build up the tear-trough area. Short-term, you can see what impact this can make. The experience level of the injector makes a big difference for this region.
I would recommend that you visit with a board certified plastic surgeon who has experience in both the surgical and non-surgical approaches to the lower lid so you can have a more detailed discussion of your concerns.
Your photos do show the fullness of your lower eyelid and the hollowness below them. A transconjunctival lower blepharoplasty to help address the fat is an option. This sill won't improve the hollowing of your cheek though which contributes to your shadow. You may also consider fillers in this area (although the are temporary) which is less invasive. It is also more affordable at first but in the long term starting at age 18 would add up to quite a lot of money.
I'd recommend you consult with a facial plastic surgeon or oculoplastic surgeon. As far as timing, if you are thinking surgery then the sooner your consult the better so you can reserve your spot on the surgical schedule.
I hope this helps and good luck.
From photos attached, it does appear you would benefit long-term from transconjunctival lower blepharoplasty with fat repositioning. See link below for more details. And yes, oculoplastic specialist is ideal.
I actually think you would do much better with fillers than with lower blepharoplasty. You have much more of a hollow than an issue with herniated fat. I suspect the bulge we are looking at is actually soft tissue sitting on your exposed orbital rim. Ultimately you have a negative vector cheek. Put your finger on the top of the bulge. You will feel it is firm. What you are feeling is not herniated fat which is what we operate on with lower eyelid surgery. Instead you are feeling the orbital rim. By filling with hyaluronic acid fillers this area is blended with the cheek. In your life time you may eventual need lower eyelid surgery but for a very long time, the fillers will be a much better answer. Avoid permanent fillers like fat which are going to make scar. The hyaluronic acid fillers can be adjusted as need over time. Best of luck and please be careful what you look for.
Thank you for your question and photos.
It appears you will benefit from a lower bleph to reposition and possibly reduce the fat that is found in that area. I recommend you begin searching for your surgeon now. Have a few consultations and choose the PS you feel most comfortable performing this procedure. Open communication and a clear picture of what to expect is key for a successful outcome. Hope this helps.
Best wishes and kind regards,