I Am Having Surgery to Remove Bags from Under my Eyes in April. Can I Have Fillers Injected There? (photo)

I have under eye bags which I have booked to have removed in April 2013, but I was wondering if I could have filler injected in to the hollow areas until then or will this be a contra-indication?

Doctor Answers 7

Eye bags and fillers

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There is no need to perform fillers in that eyelids prior to surgery.  It will give the surgeon an artificial anatomy which is not in your best interest.  Best to wait until after the surgery to see if you even need fillers there

Blepharoplasty for Eye Bags and Fillers to Improve Volume in Eyelid-Cheek Area

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Eye bags are caused by fat and that fat prolapses forward called Lower Eyelid Fat Prolapse. This means that it is like a hernia where fat is pushed forward. By pushing forward, it may create a trough or a valley. The hollow area looks deeper like a valley because the fat pocket adjacent to it is high.


To reduce that fat pocket, I suggest doing a procedure called lower eyelid blepharoplasty. For patients who do not need any skin reduction, I suggest another procedure called transconjunctival  blepharoplasty. In this procedure, fat is sculpted so that it doesn’t appear to be pushed forward.

However, facial aging, fat prolapse, as well as hollowing may simultaneously happen especially in the eyelid-cheek area. I typically help my patients to enhance their overall appearance by adding volume to the cheek area and to the transition area called the eyelid-cheek junction or the tear trough area.

If your fat pocket is pushing forward too much, a filler may not camouflage that fat pocket. So I help patients in that case by using a little amount of Restylane along the tear trough area to camouflage the fat. There are also some patients who have fillers placed, but eventually their fat pocket and the filler creates a larger bag.

Based on your photos, I think that you will benefit more from having  lower eyelid blepharoplasty, but also consider fillers as part of your overall eye and cheek rejuvenation plan. I hope that was helpful, and thanks again for your question.

Fillers Before Surgery

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In most cases it's possible to have fillers before surgery, usually because these fillers will not be going directly in the area manipulated during the operation. However, I would suggest checking with your physician, and having the same physician inject them so they know exactly where they have placed the product. Best of luck! 

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon

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I think it would be a mistake to have fillers now.

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You are just muddying the water.  Hopefully, your surgeon will perform a tailored surgery based on your issues.  If you change things with the fillers, you are basically asking the surgery to adjust surgery to your lower eyelids with fillers on board.  Ultimately, your surgeon is the person to ask about having this service before surgery.  If you were my patient, I would advise against having this before the April surgery.

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

In most cases, "bags" under the eyes are better treated with fillers than with surgery

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While there are some times, when the fat under the eyes must be removed to adequately treated under eye bags, 90% of the patients I see in San Francisco benefit more from having fillers placed in the transition area between the eyes and the cheeks.


It's probably worth trying fillers first to make sure you need the surgery.  I would recommend using Restylane under the eyes and going to someone who specializes in under the eye treatments.

Are fillers okay under eyes before surgery?

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It may or may not be possible to have fillers injected under your eyes now, before your surgery in April.  The type of filler used would be important to know.  I would check with the surgeon who will be performing your eyelid surgery to see what his or her preference is.  If there is any question, I would err of the side of not using the filler now.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Lower Eyelid Bags

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It is very important to preserve (or restore) soft tissue volume in the lower lid. When I review with eyelid surgery patients some photographs from their twenties, in most cases we find that years ago there was no visible demarcation between lid and cheek, but instead a smooth, gently convex curve extending downward from the lower lid margin.

In patients who have developed deep 'tear troughs' at the junction of the lower lid and cheek, adjacent to the side of the nose, the meticulous grafting of fat harvested from the patient's abdomen, hips or thighs can build this area back up and nicely restore a more youthful contour. In some blepharoplasty patients this depression or 'hollow' extends horizontally across the entire junction of the lower lid and cheek, and this must be corrected to obtain the ideal postoperative result.

In select patients, lower lid rejuvenation may consist of conservative reduction (not removal) of the lower lid fat pads or 'bags', in combination with structural fat grafting of the 'tear trough' hollow immediately below. As with all aesthetic surgical procedures, it is absolutely essential to customize the surgical plan to the specific needs of every patient.

Be sure to view many, many before and after photos before selecting your surgeon

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 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.