Considering lower blepharoplasty for genetic eyebags. Would fillers be a better option because of my age? (Photo)

As a practicing oculofacial plastic surgeon for 20 years, I
have operated on people as young as 14-years-old for bags under the eyes. Eye bags
runs in families and I’ve actually operated on 3 generations in the same
family. There are some key important factors that will help you decide which
option is right for you. The first is how prominent the bags are. In your
photo, it appears that they are relatively prominent, but lighting and other
factors can impact how 3-dimensional the bags are. If the bags are very subtle,
then they may be camouflaged with a filler like Restylane or other hyaluronic
acid. But if the bags are more prominent especially when you look up, and they
bulge forward and become even more prominent, then you should consider a lower
eyelid blepharoplasty. In a younger person like you, I would typically do a
transconjunctival blepharoplasty.



In addition, allergies accumulate a lot of fluid in the eye
area. Management of allergies is very important when you are considering
rejuvenation of the lower eyelids. If your eyes are itchy or if you have watery
eyes and you need eye drops, those things should be managed. If you need to
take antihistamines, then take them. Allergies can still affect the appearance
of your under eye area.



When the puffiness is removed, even if you have allergies, it
won’t look as puffy as when the fat pockets were there. You are probably best
served with a blepharoplasty as opposed to using fillers. But as mentioned,
3-dimensionality is something that can only be appreciated in a physical
examination.



Skin quality with allergies is also an issue so you have to
think about good topical skin care. Sometimes people with chronic allergies rub
their eyes a lot and the skin becomes irregular and has an aged appearance. In
our practice, we would routinely do a platelet-rich plasma injection and the
use of fractional CO2 laser. However, it is important first to do a physical
exam.



If your mother is doing her research, it will be good for you
to tag along and have a consultation. I recently did a facelift and eyelift on
a mother and daughter and they supported each other very nicely during their
healing process. This is worth considering when you do your consultation. Most
importantly, understand the level of fat prolapse you have. If it’s beyond a
certain level, you’re probably best served with a lower eyelid blepharoplasty. I hope that was
helpful, I wish you the best of luck, and thank you for your question.

You don't mention your age, but obviously, you are quite young.  I think the camera angle and lighting are probably making the hollows under your eyes look more prominent than they typically appear in -person. You certainly are not a candidate for lower blepharoplasty. I find the result of fillers under the eyes unpredictable at best, and sometimes disastrous. At some point in the future, you might consider conservative structural fat   grafting  performed by a plastic surgeon with considerable experience and expertise in creating lasting and natural looking results from this procedure. At this moment, the best option might be the use of make up under your eyes.