Which Laser is the Best Applicable to Rid Under Eye Bags?

Question

I am 21, and have severe under eye bags caused by genetics and blood vessels. Recently I was recommended to use a pulsed dye laser to eliminate my bags. Opinions? Other options?

Larry S. Nichter, MD, MS, FACS · Answer

Almost impossible to answer with out photos and/or an exam. Although you can camouflage the problem in certain cases with fillers, a blepharoplasty is generally recommended.
Patients who would benefit from a blepharoplasty include those who experience:
	•	Excessive, sagging, or wrinkled upper or lower eyelid skin.
	•	Excess upper eyelid skin that interferes with vision.
	•	Loss of your natural upper eyelid crease
	•	If you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.
	•	Orbital Rim Show: visibility of the bone under the eye sometimes contributing to a dark ring or shadowing.
Normally, everyone has a small amount of fat around the eyes. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags.” Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a profound effect on one’s appearance giving a tired or haggard appearance. An attractive face with these early signs of aging can affect a patient’s self-image, attitude and sense of well-being.

Thomas Buonassisi, MD · Answer

Without seeing your photos I can only guess that your eyelids are much like many of my blepharoplasty patients. Even at a young age, bulging fat from within the eye socket bulges the ovelying skin and can make you look tired. There are no lasers that can be used to selectively remove fat and blindly liposuctioning within  your eye socket ? you can understand why that's not done.

	Precise removal of the fat under direct vision by a surgeon is the only long lasting solution. This can be done without any external incissions, takes about 30 minutes and is essentially painless.The procedure is called a transconjuncitval lower lid Blepharoplasty.  Fillers can be used as a temporary alternative to make the skin around the eyebags more full ,thereby camouflaging the underlying problem. Have a look at the video below and see if your eyelids have similar features to the patients in our video who had the surgery

Michael I. Echavez, MD · Answer

Lasers applied externally to the skin, including the pulsed dye laser, will have no effect on under eye bags. A pulsed dye laser can potentially be used to treat under eye blood vessels if they are small capillaries. Under eye bags are due to protrusion of fat, and these either need to be surgically addressed or sometimes a filler can be used under the bags to help hide them.

R. Stephen Mulholland, MD (retired) · Answer

Hello and thank you for your question. You should always seek the advice of a cosmetic plastic surgeon in this case, and have a complete consultation. The recommendation for a pulsed dye laser will not assist nor is it typically used in the treatment of bags under eyes. The cause of the bags must be assessed and then a treatment will be recommended, either surgically or non-surgically. There are many options and some will require more risk and downtime, including blepharoplasty and some radio frequency devices. I can only assume that the laser suggested was to reduce the vessel visibility in the area? If so, you have many options for that as well but again, it is difficult to recommend a treatment without visually assessing you. I recommend seeking the advice of your local cosmetic plastic surgeon to see what all your options are.

Which Laser is the Best Applicable to Rid Under Eye Bags?

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