When I smile my eyelids look swollen & I have eye bags under eyes. How do I treat this?

Doctor Answers 4

Lower lid bags

Excess fat, skin, muscle and even swelling can all contribute to lower lid bags. A detailed consultation will reveal which of these is contributing the most to your individual issue. There are excellent treatment options for each of these ranging from injections to laser to surgery. 
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.
Cameron Chesnut
#realself500 Physician

Spokane Dermatologic Surgeon
4.9 out of 5 stars 65 reviews

Lower Blepharoplasty Removes Eye Bags

While I would need to see you in person to evaluate your situation, bags under the eyes are generally caused by pockets of fat. These can be moved into a better location during lower blepharoplasty. If there is excess skin present, that can be removed during the same procedure. The heaviness in your upper lids could be caused by a number of factors, but might be resolved by upper blepharoplasty, which would open the eyes.  I hope this helps.

Bags under the eyes when smiling

When performing a lower blepharoplasty procedure, the amount of fat and skin that is removed it is determined at rest, not upon animation.  The fat is removed from the inside approach, also known as a trans-conjunctival approach.  If there is excess skin present at rest, a small pinch technique is performed at the lash line.  In our practice this incision was closed with tissue glue.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

The expression "eye bag" is used pretty loosely.

You need a personal consultation (or at least post a photograph) to address your concerns and determine what is needed to aesthetically help you.  While some dermatologist do mid face treatment and even eyelid surgery, generally, I recommend seeing an aesthetically oriented oculoplastic surgeon for this assessment.  Finding an individual like this may be challenging where you live.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 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.