Age 40, female - desperately wanting dark bag to go away - is this fixable? (Photos)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Thank you for submitting your question and photos. Though you’ve already had a blepharoplasty procedure with fat grafting, it’s possible a second surgery would benefit you the most. The goal would be to create a seamless transition from the lower eye to the upper cheek area for a smooth and rejuvenated appearance.
Excess puffiness can generally be fixed by repositioning, sculpting, or removing the fat in this area. Following up with a chemical peel or laser resurfacing treatment can stimulate collagen production and maintain skin elasticity in the lower lid. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your concerns and medical history. They should be able to help you make the right decision that will achieve your aesthetic goals.

It appears that correction with a small volume of micro and nano fat grafts may help this condition. In person consultation with a board certified plastic surgeon, with significant experience in periorbital fat grafting is recommended. Good luck.

Thanks for the very nicely posted series of photos. But in person or virtual is so much better! I think doing fat grafts can be great but in some cases the fat grows or enlarges since it is living tissue. I suspect this is what happened in your case. There are options of low dose fat melting injections (like hyper diluted KyBella or PDA) to melt fat in few sessions. Or re operation to remove superficial fat. Might recommend doing only with ultrasound guided injections or surgery. Expect fees in the $5,000+++ ranges.