Undereye Bags at 20? (photo)

I have bad eye bags under my eyes. My mother also suffers from this but she didn't develop her bags until she was in her later 30's. Its worse when I smile obviously and it looks horrible under normal lights. Its worse on one side which is the side I sleep on. Am I a good candidate for surgery or injections? I also look tired and I have been suffering with this since I was 16. Any advice would be appreciated. Thank you.

Doctor Answers 4

Under eye bags

It is not that uncommon to see this problem , even at your age.  Just make sure any potential allergies are not causing these bags.  The best treatment for this problem is a lower blepharoplasty performed thru a transconjunctival approach.  The incisions are all inside the eyelid.  It takes about 30 minutes under a general anesthesia and expect about 10 days of some degree of swelling and bruising afterwards. Your problem will not be solved with fillers.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Transconjunctival blepharoplasty is your best option, and it leaves no scar

Thank you for your question.  You are wondering about having eye bags at age 20, and also said that your mother started having them in her 30s.  You are on the right track because eye bags have more to do with genetics than with age.  In my practice, I had a patient who was only 14-years-old with a similar problem, and he was teased at school for being on drugs because of his large eye bags.

The true cause of having large under eye bags is due to anatomy.  The cause of eye bags are fat pockets that are normally in the under eye area.  In various times of life these fat pockets can get pushed forward due to factors like genetics, or environmental factors like smoking or allergies.  This is known as lower eyelid fat prolapse, or herniated fat, or simply fat prolapse.  The condition makes the eyes puffy all the time, and automatically makes the eyes look tired.

So what I would personally recommend for you is a procedure called transconjunctival blepharoplasty.  What this involves is addressing the fat pockets from inside the eyelids, and reducing, sculpting, and shaping them for a natural contour.  An important thing to remember with transconjunctival blepharoplasty is that since it's done from the inside of the eyelid, so there is no outside scar.  Even an eye doctor in a close up exam will not notice that the procedure was ever done.

When researching procedures and selecting a cosmetic surgeon, you will come across different terminology and methods of treating enlarged eye bags.  Some of these include septal tightening, fat preserving, fat transposition, deep being better than not deep, and so on.  When selecting a cosmetic surgeon to perform eyelid surgery, you want one that is at expert level that knows all these techniques so they can customize the procedure to best suit your needs.

There are also other treatments to help with skin quality and texture, which we often employ at the same time as the surgery, or often after.   Addressing other skin issues is important as ongoing maintenance and management to keep the eyes continuously looking fresh and healthy.  I hope this was helpful to you, and thank you again for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Undereye Bags at 20?

 I know that this sounds surprising but there are a group of teens and early twenty year olds that develop lower eyelid fat bags.  Lower Eyelid Surgery remains the treatment of choice despite the age.  The procedure takes about 30 minutes and has a quick recovery time.  Hope this helps. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Candidate for lower lid blepharoplasty at young age

Lower lid blepharoplasty for fat removal on patients in their 20's is not that uncommon. Based on your photos, you appear to have pseudoherniation of periorbital lower lid fat. Surgery consisting of a transconjunctival blepharoplasty in which there are no externally visible incisions should remove the fat bags and make you look less tired. Of course, an in-person examination by your plastic surgeon is crucial prior to making a final decision.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 2 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.