Blepharoplasty or fillers? (Photo)

Hello, I am 24 years old and ever since I was little I have had these embarrassing lines under my eyes. I don't have bags directly under my eyes but puffiness on the outer corner. some lighting I can't tell but without makeup and indoor lighting I can't stand to look at myself. I always look tired. would I be a good candidate for lower blepharoplasty or would fillers be a better option? ( This is a repost with more pictures, as requested)

Doctor Answers 16

Lower blepharoplasty vs. filler

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You have both under eye bags and hollowness. Options include transconjunctival lower blepharoplasty with fat/bag repositioning vs. filler injection in the relative hollow part. Best to get in person consultation. See an oculoplastic specialist.

Fillers work well for hollows, blepharoplasty works well for bags

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It’s hard to say without an in-person exam which treatment option is best for you. It appears that you have some hollowness under the eyes, which the use of fillers can often treat effectively. Lower blepharoplasty is a better option if you have prominent bags under your eyes. Please visit a board-certified facial plastic surgeon for a consultation to see which eye enhancement procedure will benefit you most. I hope this helps.

Lower eyelid problems

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In some of the pictures, it appears as if you may have "malar bags," which are a different problem than the more typical lower eyelid "bags."  You also show the sunken area called the "tear trough" depression, as well as early true bag formation.  These latter two issues are best treated with the trans-conjunctival lower blepharoplasty, release of the attachments internally (the "arcus marginalis"), and advancement of a "fat flap" to fill the depression.  The results can be outstanding, with no visible scars, and permanent improvement.  The malar bags may require a separate treatment, however.  An in person evaluation is essential to properly assess your situation and discuss your goals.

Fillers versus a blepharoplasty at age 24?

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 An in person examination and consultation is usually required to make the determination between placement of fillers or surgery at a young age. It is important to evaluate the eyelids with a straight ahead gaze in all 3 dimensions, which his demonstrated on our photo gallery link below

Blepharoplasty or Fillers

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Dear ercaaa, An in office consultation would be best to advise you of the procedures that would benefit you most. With that said, in many patients your age or patients with the same concerns I typically perform and endoscopic browlift with a mid face suspension. In this procedure I undermine down below the malar region and release the skin, soft tissue and muscle and lift it laterally and upward where the tissues reattach and provide a youthful appearance to the face with no tell tale signs of surgery. In some patients this is done in conjunction with lower lid blepharoplasty however this is determined during consultation. Personally I would suggest avoiding any injections to the area with fillers as you appear to have thin skin and this may further aggravate your current concerns. See the link below and video above of examples. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 213 reviews

Correcting Under Eye Lines in the Young

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Although it is impossible to give advice without an exam, you appear to be an excellent candidate for fillers. What you have is quite common, there is a depression just above the small muscles that attach at the edge of the orbital bone. Surgery can correct this but what is necessary is not a regular part of a blephatpolasty. When done correctly, a filler is easier and safer, I would probable start with injection of Voluma and, if that works well, do fat the next time. Make sure you see someone with significant experience with all these modalities. ( See

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Blepharoplasty or fillers?

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Each is a good option to consider either together or first fillers and then if necessary a blepharoplasty.
You need a face to face consultation with a Bd Certified plastic surgeon to discuss options and preferences.  Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Dark circle

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I think you are more of a filler candidate than a surgery candidate. I use either Belotero or Bellafill.

Lower eyelid

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You are concerned with the lines about your lower eye lids and not the bags, etc.  I would avoid fillers in this area because the skin is so thin and it could make it lumpy.  Also you do not have enough excess skin to surgically excise.  I feel your solution would be a light treatment of laser, to diminish the lines and tighten the skin.

Lower Eyelid rejuvenation

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Thanks for your question. Based on your photos, you could go in either direction, but considering your age I would first consider fillers. This would nicely fill in the trough and provide the result you are looking for. Good luck!

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.