I Have Deep, Dark Under Eye Bags. I Would Love to Lessen the Look of Them. What Do You Suggest?

I have dark bags under my eyes. They are all I see. What do you suggest to lesson the look of them? I have heard Sculptra but hear such bad things are thre any other procedures that can help?

Doctor Answers 5

Dark circles under the eyelids

Dark discoloration of the lower lids is difficult to treat.  The fatty deposits causing the bags are removed thru an incision on the inside of the eyelid.  Excess skin is removed by a pinch technique along the outer lash line.  This is closed with Histocryl tissue glue.  We do not recommend filler  injections into the eyelids

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Treatment of Dark Circles and Under Eye Bags

Thank you for your question. Improvement of the under-eye area is one of the most commonly requested procedures in facial plastic surgery. It is also one of the most complex problems to address because of the various factors which may contribute in each person's situation. Briefly, some of those factors include genetic factors, medical conditions, skin color and quality, orbital fat protrusion (bulging), volume loss and/or cheek or midface ptosis (sagging). For optimal treatment, the doctor must determine which factors are present and each contributor may be improved.


*If the problem is related to skin color or quality factors alone, then laser treatments or chemical peeling may be employed successfully.
*If part of the reason for the unfavorable appearance involves the undulating contour of the lower eyelid-cheek junction, then carefully-placed hyaluronic-acid based filler may be used to improve the appearance. Filler may be placed into volume-deficient or depressed areas to improve the contour and improve the appearance of unfavorable shadows.
*In other cases, lower eyelid blepharoplasty (to contour or reposition bulging lower eyelid fat) or a midface or cheek lift may be indicated. I hope that helps.
*True under eye bags or festoons are less common and may present a challenge to improve without surgery.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 131 reviews

Treatment of Dark Circles and Under Eye Bags

The main issue is whether you have dark circles or actual bags under your eyes. Dark circles can be due to lower eyelid skin discoloration and/or hollowing under the eyes. Discoloration can sometimes be treated with laser or a chemical peel. Lowe lid hollows can be improved with an injectable filler, the choice of which depends on your eyelid anatomy. Bags under the eyes are often the result of herniated fat and is treated surgically. Sending a photograph or having an on site consultation will help determine the cause so that the most appropriate treatment is advised.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Deep, Dark Under Eye Bags

Dark under eye "bags" are a very common complaint.  But this can actually be due to quite a variety of different causes, and often more than one factor is involved!  When the look is because of bulging fat in the lower lids, a lower eyelid blepharoplasty, which removes the bags through a completely hidden incision, yields great improvement.  But if the look is due to fat loss in the upper cheek/lower eyelid rim region, a blepharoplasty would make things worse!  A "filler" or fat would be the right choice for this problem.  And pigment issues may be the real culprit, for which neither a blepharoplasty nor a "filler" would be advisable - a laser or chemical peel would make more sense.  Bottom line - the right treatment choice is always based on a proper evaluation by a cosmetic surgeon.  That is the place to start!

Lyle M. Back, MD
Cherry Hill Plastic Surgeon
4.2 out of 5 stars 14 reviews

I Have Deep, Dark Under Eye Bags. I Would Love to Lessen the Look of Them. What Do You Suggest?

The most common treatments for undereye bags include blepharoplasty to remove the bag or reposition the undereye fat as well as hyaluronic acid filler treatments to fill the area under the bag and camouflage that bag. Surgery is a long-term solution while the filler needs to be repeated about once each year. Sculptra can be injected deep along the bone of the undereye area but CANNOT be placed in the eyelid proper. Sculptra treatment of the eyelid can lead to nodules. This is well known and an experienced injector will not do this. Sculptra is very safe if used properly. I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 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.