Follow-up: Male, 22yo, considering surgery since Restylane only made it worse, am I a good candidate? (photos)

I've always had visible fat pouches under my eyes. I believe they are quite "unique" as I have yet not succeeded in finding out the term for what they've called or found someone with similar "bags" online. Everyone seems older and to have much more puffy bags concentrated underneath the eyes, while I have this large layer of fat underneath my eyes creating these creases. The pics are before restylane, which I'm having removed. Is the surgery risky? Am I too young? Am I a difficult or easy case?

Doctor Answers 8


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Judging from your photos you are right about not having the usual bags under your eyes.  Your bags are not caused by fat but by a collection of fluid.  This can not be corrected by surgery.  In general filler in the eyelid area will only make this worse but filler in the cheeks can greatly improve your appearance and help blend the bags with the cheek below.  Voluma can work wonders and I recommend trying to find a specialist familiar with this product.  Best of luck!

Boston Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

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

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This can be treated by surgery but often swelling under the eyes is genetic lymphedema (festoons) and is better treated with lasers and fillers placed appropriately. Please see an expert for an evaluation.  Ensure not too much of fat is removed if you do surgery as this can leave you looking too hollow.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Blepharoplasty in a young patient

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Blepharoplasty can reduce the laxity of the lower lid and remove some of the fatty deposits of the lower lid that protrude to produce a tired look.  However, given your pictures, fat removal will accentuate your hollows and your lack of laxity would make surgical skin excision more risky.  I would seek out an expert in facial injectables and try filler again possibly in combination with non-invasive tightening or skin resurfacing.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Follow-up: Male, 22yo, considering surgery since Restylane only made it worse, am I a good candidate?

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Hi and thanks for your photos and questions. It doesn't appear that lower eyelid surgery will address the issues which concern you, especially the fine lines which could actually be accentuated once there is any fat pad removal. I would see a surgeon who is very experienced with eyelid surgery, preferably one who is certified by the American Board of Plastic Surgery. Good luck!

Richard Chaffoo, MD, FACS, FICS
Triple Board Certified Plastic Surgeon

REstylane under eyes

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It appears from the pictures that you indentationunder your eyes that should be helped with a filler. surgery will not help this issue. Be sure you are seeing a board certified dermatologist or plastic surgeon who is skilled in this area and you should have benefit

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 reviews

Under eye bags

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It looks like the main problem is loss of volume in your upper cheeks. Adding filler to the upper cheeks in addition to the eyelids will help optimize your results. Based on the photos you submitted there is not a lot of extra fat to remove. Removing fat from the eyelids with lower blepharoplasty surgery is probably not the best option for you.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
4.9 out of 5 stars 183 reviews

Good candidate for lower blepharoplasty?

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Thank you for sharing your question and posting your photos. It looks like Restylane should have given you some improvement in the appearance of your bags. Perhaps you should consider having a different doctor perform the injections. You probably are a candidate for blepharoplasty. See an Oculoplastic Surgeon for comprehensive evaluation and discussion of potential treatment options. Good luck,

Restylane and Belotero Under the Eyes

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There are times when fillers such as Restylane  and Belotero can help improve the under eye areas and times when they can make the situation worse.  I would consult an experienced injector to see if you have different results since surgery at a young age is not necessarily the answer.  Best, Dr. Green

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.