I Have Hereditary Eye Bags I Need Help on What to Do. It is Not Excess Fat but a Different Color? (photo)

Please see picture of eye bags Im young still in my 20's and I dont know what to do about my hereditary eye bags. Fillers? Surgery? otc supplementals? etc. In the pic one eye underneath has make up and the other does not. Thanks In Advanced

Doctor Answers 7

Hereditary eye bag treatment

As you have seen in yourself, sometimes bags beneath the eyes do not come from aging but from your parents.  There are basically two options to help.  One option is to have surgery to remove some of the fat that causes the fullness.  The other is to place a filler beneath the bag to even out the appearance in the area.  The filler I would recommend for that area would be Restylane and it could last longer than a year in that location.  The surgical result would last much longer.

San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Bags-Lower Eyelid

 Fortunately your condition does not appear to be that severe yet. A tranconjuntival (TC) lower lid bletharoplasty may be your ticket to get rid of those bags. The incision is actually made in the pinky part of the lower lid called the conjuntiva so, there is usually no external scar. Consider a consult with a member of the ASAPS in your area. They are often experts in what is called occuloplastic surgery or plastic surgery of the eye area.  Best,


Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 9 reviews

You need to be careful what you look for.

It is probable for quite sometime, a properly done Restylane under eye filler service would be all that you need.  It is possible that a lower eyelid surgery might for quite sometime be all that you need.  The lower eyelid surgery that is right for you very much depends on a personal examination to determine if a lower eyelid fat pad is the cause of your lower eyelid fullness.  Personally I think anytime you can have something great done without surgery, that is a pretty good thing so be careful of being pushed into surgery.  Find someone who really makes sense to you.  Seeing the right surgeon makes all the difference.  An oculoplastic surgeon (see the ASOPRS website for their directory) can be a good choice.  Just remember that surgeons are not all the same. 

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Hereditary eye bags

There is a hereditary component to fatty deposits in the lower lids.  Allergies and salt intake can effect the lower lids as well.  A transconjunctival approach to the lower lids is all that is need to conservatively remove the fat pads.  This is done under a brief general anesthesia for patient comfort and safety

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Eye Bags are Best Treated with Surgery, but Blending with Fillers can be Tried

Commonly, it is believed that eye bags can be caused by salt, fluid retention, menstrual cycle, and even allergies. These factors can affect the appearance of puffiness under the eyes. One of the most popular things people do to treat these eyebags is to try every possible over the counter cream and moisturizer. And of course, none of them work. And there’s basically one reason: anatomy.

Essentially, we’re dealing with a genetic trait called lower eyelid fat prolapse. This means that the fat that is normally around the eyes pushes forward. And when it pushes forward, it creates a bulge like a hernia. That hernia causes a mountain-like appearance over the front of the eye. This will eventually create a valley-like hollow. Non-surgical physicians fill that hollow with Restylane or some other fillers that will not solve the problem and even create additional puffiness.

If you’re really not ready for some type of lower eyelid surgery, which means reducing the fat pockets, we can try a trial with a moderate amount of filler. In this procedure, I don’t try to eliminate the bag altogether. I try to soften it so that it looks like the natural contour of your eyes. However, when people try to eliminate it altogether using fillers only, very often they get two bags.

If you are ready to consider surgery, I could do a procedure called transconjunctival blepharoplasty for someone who’s young with dark skin. In this procedure, I sculpt the fat and arrange it so that the procedure is all done from the inside of the eyelid. And by doing it that way, there is no scar on the outside. Essentially, you look like yourself, just more rested.

Pigment and anatomy can lead to dark circles under the eyes, which can be remedied by improving skin quality and texture.  There are many options that I offer to my patients. One is the procedure using platelet rich plasma that is derived from your own blood and we to improve skin quality under the eyes. We also offer skin products and skin treatments that help improve this area.


You should have a clear understanding of all these factors before you commit to any one particular solution. This way, you have a perspective on your options, your choices and eventually have a plan of what is right for you. I hope this was helpful for you and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Eye Bag Treatment

I would recommend you start with something conservative, such as an injectable like Radiesse or Restylane to fill in the tear trough hollowness. This could camoflage the bags themselves. If you don't think that is enough, you could consider a blepharoplasty down the line.

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Procedure tired eyes, eyelid bags

At a young age it would be best to start with a filler such as Restylane or Radiesse.  These will mostly correct the trough beneath the lids. 

Fat injections or surgical excision, internal laser (Cellulaze Sidelaze) can offer longer lasting results.

Please consult with a Board Certified Plastic Surgeon in person prior to making any treatment decisions.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 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.