What procedure works best to tackle under eye bags and tear troughs? Could micro-needling work as well as injectables?

Thanks for the question; however, photos would be most helpful to guide you.  If you have a large bulge from excessive fat pads, your tear trough may appear deeper.  In this situation, you may opt for a transconjunctival blepharoplasty, where some fat is removed, and some brought into the tear trough.  If your fat pads aren’t prominent, a filler may be sufficient to fill the area.  When dealing with the overlying skin, microneedling or fractionated CO2 laser can be used to tighten the skin.  Hope this helps!

Hi @Jeelsie9. I recommend an in-person consultation to discuss your aesthetic goals and the best treatment options tailored to your face.

Best of luck,

Dr. Nima

There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel, CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. An evaluation would be needed to determine if a surgical skin and/or fat removal would be the best long-term solution for you. I suggest getting a formal evaluation with a cosmetic dermatologist to develop a personalized treatment plan that works for you. Best, Dr. Emer.

Thanks for your question. "Eye bags" mean different things to different people. If you would consider sending in some photos that would help to clarify your concerns. In general what most people mean by eye bags is a puffy look to the lower lid due to fat that bulges forward from the orbital space (the socket that your eye ball sits in). This fat can accentuate the tear trough by creating a shadow from above. There is no external device that can remove fat from your orbit. If you feel removing this fat would significantly improve the appearance of your lower lid then you are probably right. Have this fat removed from inside the eyelid with an internal lower lid blepharoplasty. It takes about 20 minutes and can be done with light sedation.This is a very effective treatment that can often completely correct the problem. This procedure will not improve the quality of the overlying skin.It what you have is  faint wrinkling and sun damaged skin along the lower lid and this is the main problem then radiofrequency augmented microneedling (like the Morpheus 8 or others) may give you some improvement in the quality of the skin. There are lots of other options for improving your skin using lasers , chemical peals and broad band light as well. They will not remove the fat bulge or fill the tear trough in any way.Fillers however can be used to try and camouflage the tear trough by filling the area to blend in with the fat bulge above. This of course gives a full look . If  that is what you think will look good on you then it's a good option as well. Fillers will not improve the skin quality and of course will not remove the fat bulge.The important thing is to have a consultation at a clinic that performs all the above treatments and decide how much of an improvement you really need to be satisfied.

Dear Jeelsie9:     Thank you for your question. Without photographs a precise answer is imposible. I believe hyaluronic acid based fillers like Restylane & Juvederm are good nonsurgical treatment options for prominent tear troughs and undereye volume loss. Other treatments like laser, microneedling, Hydofacial, and Ultherapy can be used to improve the quality of the skin around the eyes but fillers are best for addressing volume loss.  Good luck and I hope this helps!

I think hyaluronic acid based fillers like Restylane are good nonsurgical treatment options for prominent tear troughs and undereye volume loss. Other treatments like laser, microneedling, and RF can be used to improve the quality of the skin around the eyes but fillers is best for addressing volume loss.