Lower Blepharoplasty for Tear Trough Bags?

Lower eyelid lifts or blepharoplasty can improve the appearance of the bags under your eyes and the tear trough as well, depending on the technique used.
With modern techniques, there are bascially three methods to treat the lower eyelid bulges:
1) Fat removal - Here the excess fat is removed. This will not affect the tear trough significantly, although it can in select cases.
2) Fat Hernia Repair - Here the fat is placed back where it came from and the lowereyelid tissues are closed to keep it in place. This is akin to treating the fat like a hernia repair, and just putting it back into its original position. This rarely affects the tear trough.
3) Fat Repositioning - This is sometimes called fat transposition or septal reset. Here the fat is repositioned to cover the hollowness beneath the protruding fat. This is your best bet for improving the tear trough.
Make sure you see a surgeon experienced in modern blepharoplasty technques. They will have before and after photos to show you so that you will know what you can expect.

The depression beneath the lower eyelid at the beginning of the tear trough near the nose and extending out beneath the lower eyelid can be corrected by a VERY SPECIFIC type of lower blepharoplasty. Most patients call this condition dark circles under the eyes. The tear trough is more commonly associated with the depression as it moves out toward the cheek.
Traditional lower blepharoplasty with fat removal may make the deporession near the lower eyelid worse.
The modern approach to this problem is a transconjunctival lower blepharoplasty (incision on the inside of the lower eyelid) and fat grafting to plump the depression beneath the lower eyelid-which is properly called the nasal jugal fold or what I call the arcus marginalis deformity.
Properly done, this procedure provides excellent results.
Although the procedure has been done through traditional external blepharoplasty incision, the external incision weakens eyelid support and can cause ectropion.
Find an expert board certified plastic surgeon with experience in eyelid surgery.
Avoid fillers--they are usually put in too low and actually make the tear trough near the eye look worse.