What's better for my puffy under eyes & eye bags, laser lipo or lower blepharoplasty? (Photos)

Lower blepharoplasty with fat repositioning (not excision) is the gold standard for lower eyelid rejuvenation. Do not consider liposuction for this delicate area. Risk of liposuction in this region includes ocular muscle damage and double vision.
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Hi @AuntKT. Thank you for sending your photos-- you would be a great candidate for a transconjunctival lower blepharoplasty with fat transfer. A lower blepharoplasty will address the herniated fat pads and excess skin under your eyes giving you a more refreshed and rested appearance. Best of luck, Dr. Nima!

For puffiness and sagging under the eyes, we often use Renuvion helium plasma radiofrequency energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Eyelid Lift.' The focused heating tightens and peels the upper layers of skin with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​ See an expert to determine if this is the best solution for you. Best, Dr. Emer

Thank you for your question and photo submitted. Based off your information provided, you seem to be a great candidate for a lower blepharoplasty. This will help remove the excess skin, as well as, fat pad causing the puffiness. An in-person consultation will be the deciding factor on whether fat disposition or fat transfer may also be needed. This will give the undereye an overall rejuvenation. The next step to take would be finding a qualified and experienced Board Certified plastic surgeon to do a full evaluation and provide you with a designated treatment plan to reach your desired goals.

A lower lid transconjunctival blepharoplasty would remove this fat and give you a nice lower lid/cheek contour. There is no role for liposuction in this area.

Based on limited photos- it appears that you are candidate for Lower lid blepharoplasty with possible fat repositioning, and possible PRF treatments . I do not recommend liposuction in that area as this is not the appropriate treatment for this delicate area. I suggest that you seek an experienced Board Certified PS for in person consultation.

I performed scarless transconjunctival lower eyelid blepharoplasty and typically will reposition the fat into the hollow areas to treat lower eyelid bags. This will give you a smooth lower eyelid-midface junction continuum.

The only laser I perform around the eyes is fractionated CO2 laser resurfacing to rejuvenate and tighten the skin.

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See an Oculofacial plastic surgeon for a proper exam and recommendations.

Common reasons for lower blepharoplasty include tear trough deformity or pseudoherniation of the orbital fat. An in-person exam would provide a more accurate diagnosis, but preliminarily based on your photos it does appear you have pseudoherniation of fat creating "eye bags.” They should also be more prominent when you look up. Transconjunctival lower blepharoplasty with fat repositioning will provide nice results and a better lid-cheek transition in this case. @drdonyoo

Hello AuntKT. We won't try to scare you by answering your question :). You are a candidate for surgical revision (lower blepharoplasty) or dermal fillers. Laser lipo would not be appropriate. An in person evaluation will help to clarify the pros and cons to each procedure, but essentially filler can help, but will camouflage the protruding portion whereas surgical revision can help with revising that bumpy area. Surgical revision may also not address volume (without fat grafting), so a combination of the two options may work best. Best of luck.

There are a couple of treatments that can help improve under eye bags. An injectable filler can be used to help camouflage the bags. This is done by placing the filler under the bags to help blend the area. Fillers are temporary but could last a year or so in that area. The other treatment option is surgery to directly deal with the protruding fat. This is a much longer lasting option and frequently, this does not need to be repeated with time.