I am now 23, but I have had under eye bags since I was a little child. How can I remove these? (photos)

You are probably a great candidate for a blepharoplasty, eyelid lift procedure. Of all the features on our faces, our eyes are the most prominent indicators of our mood, energy level, and youth. Sagging, drooping, or tired-looking eyes can make us look older than we really feel. Eyelid surgery, or blepharoplasty, is a plastic surgical procedure designed to improve the message our eyes send to those around us.Who is a candidate?Patients who would benefit from a blepharoplasty include those who experience:
• Excessive, sagging, or wrinkled upper or lower eyelid skin.
• Excess upper eyelid skin that interferes with vision.
• Loss of your natural upper eyelid crease
• If you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.
• Orbital Rim Show: visibility of the bone under the eye sometimes contributing to a dark ring or shadowing.
Normally, everyone has a small amount of fat around the eyes. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags.” Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a profound effect on one’s appearance giving a tired or haggard appearance. An attractive face with these early signs of aging can affect a patient’s self-image, attitude and sense of well-being.
Intended ResultA blepharoplasty is a procedure designed to improve the appearance of the eyelid area. This may involve removing excess skin and if needed tightening the surrounding muscle resulting in a more youthful, refreshed appearance. This procedure can treat both the upper and lower eyelids depending on the unique needs of the patient.

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

Dear Coronda, You appear to have fullness in the lower lid area as a result of fat pushing through the orbital septum into the lower lid space. This usually occurs in the 40's but some people can have this problem at earlier ages. Best option would be to see an Oculoplastic Surgeon in your area to discuss a transconjunctival blepaharoplasty to remove or relocate the fullness is this area.I hope this was helpful. 

There are a variety of different options that can treat under eye bags depending on the specific patients needs and anatomy. Facial fillers can utilized to fill in eye hollows and are non surgical.  By artistically filling the hollows to the point where it is at the same level as the most prominent portion of the "bag", the "bag" can effectively be made to disappear. Specific lasers and micro needling can also help improve the tone and texture in the area, but are generally less effective. Finally, a lower blepharoplasty, is a surgical approach that can reduce baggy eyelids by removing excess skin and protruding fat thus improving the appearance of the lower eyelids.  I often transfer fat during the blepharoplasty to provide a smooth transition from the lower eyelid into the cheek to eliminate the  dark hollow's or "tear troughs".  I recommend going for a consultation with a board certified plastic or oculoplastic specialist to determine best corrective treatment plan.

Thank you for the question and the photo. Though nonsurgical treatments may offer some benefit in terms of camouflage, I would recommend a transconjunctival lower blepharoplasty. In this procedure, the fat pads under the eye are carefully reduced through an incision on the inside of the eyelid. If there is any skin excess, this can be trimmed immediately under the eyelashes. The procedure can be done with local anesthesia and light sedation. Recovery is generally pretty quick.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

See an oculoplastic specialist for consideration of transconjunctival lower blepharoplasty with fat repositioning. It would address the fat bags and hollowness, concurrently, with long term results. See following surgical video and website link.

Hello Coronda,thank you for your question. Eyelid surgery can lead to a predicable and excellent result when performed on a the right candidate.  The first step for you will be to have a thorough examination by a knowledgeable surgeon.  While I am a board certified plastic surgeon and perform many eyelid and facial surgeries, I often refer patients with your findings to an ophthalmologist.  Together, we evaluate you globe projection, globe pressures, facial structure and anatomy, and outline a plan for an appropriate procedure if indicated.  The photos included are hard to interpret with regards to your bony architecture (cheek, forehead, etc).  Lower eyelid surgery may be the solution, but a thorough evaluation will help to limit potential pitfalls post surgery.

Since other members of your family also have under eye bags and you are only 23 years old, then it is most likely genetic.  The only way to really remove them is with surgery. Because you are so young, I would recommend a consultation with a double board certified plastic surgeon specializing in lower eyelid surgery.

Thank you for sharing your concerns
It is easy to fix your problems. You will require a transconjuctival blepharoplasty.
it takes about 45 minutes, day surgery, awake.
Recovery for about 10-14 days
SIncerely
GD