Under eye bags. What do you recommend? Blepharoplasty or fillers? What prices am I looking at for either? (photo)

Doctor Answers 11

Surgery or fillers

Thanks for your question and photos.  An in person exam is obviously needed to best answer your question.  In general terms, someone your age can try fillers first to see if this can help blend the transition between your lower lids and your cheek.  If you are not satisfied then lower lid surgery might be an option.  This can sometimes be performed through an incision on the inside part of your eyelid to remove and/or reposition the fat.  I would recommend an in person consultation with a board certified plastic surgeon to determine what will be the best solution. 

Under eye bags. What do you recommend? Blepharoplasty or fillers? What prices am I looking at for either?

I would recommend careful moderate eye bag removal by a trans conjunctival approach. If there are fine lines, mild laser resurfacing could be added.

Fred Suess, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 7 reviews

Under eye bags treatment

Dear vee826,
  • I would suggest going with fillers first, but it also depends on your exam
  • When you are ready, please see a specialist who can examine you and address all of your concerns

Best,Dr. Nima

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 68 reviews

Try filler first

At your young age I would suggest filler first.  Many of my patients are content with filler, and your anatomy would do well with juvederm application. Cost is about 800 dollars. If this is not satisfactory for you then you can consider more permanent options as a secondary phase such as tranconjunctival blepharoplasty and fat trimming with repositioning. Cost of about 2500 dollars.   Another option is fat transfer to this area. Cost around 1500 dollars.

David Q. Santos, MD
Bellevue Facial Plastic Surgeon
4.3 out of 5 stars 21 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

The eyes are best treated with a combination approach of fillers, lasers, microneedling/PRP for improvement. Ultherapy/thermage, venus legacy all do well for swelling or puffiness. I would suggest consulting an expert. If surgery is an option they will recommend. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Eyelid surgery puffiness

I like to do the transconjunctival approach no cuts on skin or sutures needed.  Cost all included $2500.  The results are permanent and amazing.

Afshin Farzadmehr, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

Under eye bags. What do you recommend?

Given the amount of under eye bags (fat prolapse) that you have, lower blepharoplasty would be the best long term option. Best to use transconjunctival approach with incision inside the lower eyelid, with fat repositioning to give most natural effect without making it hollow/sunken. See video and link below.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Dermal Filler Injections

Hi Vee, given your age and the lack of excess tissue under the eye, we would recommend dermal fillers.  We use Restylane in this area and 1-2 CC's is normal.  To see photos of other patients with the same concerns, view before and after pictures at the link below.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

If you have not tried lower eyelid fillers, start there.

You can always have lower eyelid surgery.  The concern I have is that you cheek bone is a little weak.  That means when you have the lower eyelid fat addressed surgically, you may still feel you need volume in the form of filler.  Given that possibility, why not simple have the filler and avoid spending money on eyelid surgery at this time.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Surgery or Fillers

Both surgery (blepharoplasty) or fillers can help with you lower eyes.  Fillers are an office treatment and have minimal downtime.  They can last 1-3 years or so.  Fillers cost much less.  Blepharoplasty works great but involves surgery is more permanent, has more downtime, and costs more.  You can search RealSelf for costs in your area.  Best wishes, Dr. Denkler

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