Is 38 too young for lower bleph (fat removal)? (Photo)

38 is not too young to do a blepharoplasty if the appearance of your lower lids concern you. Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, micro-fat grafts, and blepharoplasties. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient with your inherited anatomy, a blepharoplasty will produce the best and longest lasting cosmetic result.

Following the advice of anyone who would presume to tell you exactly what to do without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Thank you for this question. I hear this a lot from many patients in their 30s, and even 20s. Age is not the most important factor when concerned about eyelid sagging or asymmetry. Yes, sagging eyelids can be corrected with blepharoplasty or cosmetic eyelid surgery of either the upper or lower eyelids. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your genetic makeup and anatomy in addition to what exactly is bothering you. 
The lower blepharoplasty will help get rid of the under eye fat bag that are bothering you. It is also important to know that surgery doesn’t last forever, the average cosmetic surgery lasts about 7-15 years but can be longer for some people.

I would recommend that you see a board-certified plastic surgeon who is a member of both ASPS & ASAPS and has plenty of experience in eyelid surgery. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Lower eyelid surgery is a complex problem, and if performed poorly can lead to significant issues.
Based on your photos, it looks like you have tethering of the orbital malar ligament, fat herniation over top of the ligament, and some cheek hollowing. I feel that the best option for your would be release of the orbital malar ligament through a transconjunctival approach, together with transposition of the medial fat pad, and conservative reduction of the lateral fat. You may not even require any external skin removal, and may find that this alone is adequate.
Fat grafting to the area could help in addition to this, but you may find you are happy without out. Filler is always an option if you aren't sold on fat grafting.