Can I get fillers or would I need surgery on my under eye bags? (Photos)

I have had some form of under eye bags for a while now and have been researching restylane injections for correcting them. I have looked at many before and after pictures and am just wondering if I would be a candidate for the injections or would I need to get the lower lid surgery? Also if I am not a candidate for the fillers an explanation of why. Thanks in advance.

Doctor Answers 14

Filler vs. Surgery

Thanks so much for your question! Generally speaking, Restylane is most effective for improving dark circles in the under-eye area as opposed to under-eye bags. Usually the best treatment for your concerns is a small surgical procedure called a lower blepharoplasty. It is minimally invasive procedure that eliminates under-eye bags, and results in a more rejuvenated aesthetic. There is also a possibility that you could benefit from fat grafting. Patients are usually a good candidate for fat grafting if their skin has lost elasticity and becomes thin causing the support structure to loosen up. This results in the midface bones protruding out andfat atrophy which causes a hallowness in the treat trough area and a tired lower eye look.I recommend scheduling a consultation with a board certified facial plastic surgeon who can meet you in person and discuss your options. It's important to see a physician who will create a customized treatment plan based on your specific goals. Best of luck!

Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Can I get fillers or would I need surgery on my under eye bags?

It is difficult in a 2 dimensional photograph to assess whether protruding under eye fat pads can be "cancealed" with filler injection below them. Please consult a board certified aesthetic dermatologist for a consultation.  

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 9 reviews

Fillers under the eye bags

I would probably try fillers first into the tear trough to mask the appearance of the eye bags above it. Fillers in the tear trough are safe & last one year or often longer, especially if injected properly by a true cosmetic expert such as a dermatologist. If you're not sufficiently happy with the results, then surgically removing the eyebag/fat herniation is your next option.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 reviews

Can I get fillers or would I need surgery on my under eye bags?

 Hi, from the photos you do appear to have herniated fat bags in the lower eyelids of the medial and central fat pads.  A transconjunctival lower lid Blepharoplasty would be required to reduce the fat and improve the appearance of the lower eyelids.  Dermal fillers "add volume" and as such would make the bags larger, not smaller. 

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Good News-You Would Be a Good Candidate for Either Filler or Lower Eyelid Surgery

After reviewing your photos, it certainly appears as if you would be a good candidate for either of the options you mentioned.  Filler should worked very nicely to smooth the groove underneath your bags, essentially connecting the bags to your upper cheeks.  Once the groove has been filled in, the under eye bag is much less noticeable. Given that you're skin looks fairly tight, this would likely be a good option for you.  Alternatively, surgery to remove the excess fat underneath your eyes would flatten the bags.  At the same time, removing a very small amount of skin would tighten the lower eyelid skin nicely.  The only downside to a trial of filler is that if it does not give you the results you desire all you've lost is the relatively minor cost (compared to the cost of the surgery) of the filler and some time.  You can always go ahead with the surgery if the filler is not satisfactory. Good luck.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 26 reviews

Can I get fillers or would I need surgery on my under eye bags?

It appears from your pictures that your greatest benefit would be from a lower blepharoplasty surgery to remove the bags. This is generally made up of small fat pockets that are hereditary. You could add filler underneath to disguise them some, but that would be all you are doing. There is not good treatment outside of surgery to rid them permanently. It would be best to visit a board certified plastic surgeon for an in person consultation in order to get the best recommendation. 

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Eye bags

Fillers do not really benefit patients with eye bags, but can improve the appearance of the indentations under the eyes.  for treatment of true eye bags the best is surgery

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

Fillers, lasers, microneedling/PRP can all be performed to give improvement without surgery but surgery will give a permanent outcome.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Can I get fillers or would I need surgery on my under eye bags?

Hello, and thanks for your question and photos. In my experience, patients with similar patterns of facial volume loss benefit from first replacing lost volume in the anterior medial cheek area. Then, many patients also require placement of a small amount of a soft filler directly into the tear trough lines. In the hands of an experienced injector, these products could be used to achieve excellent results. In short, surgery may provide the best results (hard to say for certain based on only one photo), but I do think fillers are a good option for you, in particular if you are not ready for surgery. Hope this opinion is helpful to you. Best of luck, Dr. Frucht.    

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Fillers or surgery for under eye bags

While surgery would likely give you the most improvement, you could still consider trying a filler such as Restylane.  Surgery is more invasive, more costly, has more downtime, and more risk.  Filler injection with a cannula by an experienced doctor would help to camouflage the eye bags.  It could be worth considering if you're not ready for surgery.Regards,Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 27 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.