Lower lid bleph or fillers one eye is more pronounced. Allergies! Advice? (photos)

I have good eye muscle tone. The bags are hereditary,

Doctor Answers 6


The asymmetric fat herniation will not be satisfactorily hidden by fillers.  You will be best served by very meticulously removing more fat in that inner right corner than the left.  There are three distinct pockets of fat on each lower lid.  We now know that orbital fat herniates not because of weakened supportive tissues, but because the fat grows.  Why that pocket grew faster than the others is an interesting question, and will it grow faster than the others after repair is unknown.  After surgery, fillers can be used for fine tuning, but it would be prudent not to use fillers at the time of surgery, to evaluate the success of the procedure.

West Palm Beach Plastic Surgeon
4.8 out of 5 stars 9 reviews

Under eye area

For optimal results I think you will benefit from a combination of surgery and fillers.  The lower lid surgery will address the fat deposits and the excess skin.  If additional contouring is needed you can have fillers injected to give a smooth look to the area.  Visit with a board certified plastic surgeon in your area to learn more.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 28 reviews

Lower bleph or fillers

Even if you have allergies, there is excess fatty tissue in your lower eyelids which is best treated with lower blepharoplasty surgery. I often use fillers to optimize the results of lower eyelid surgery after the swelling from surgery has subsided. If you are not interested in surgery, fillers alone would help, but the results will not be as good as with surgery.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 145 reviews

Under-Eye Advice: Fillers, lasers, microneedling/prp

A combination approach would be best. This can be improved with lower eyelid surgery or fillers, lasers, and microneedling/PRP. See an expert. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Lower lid bleph or fillers one eye is more pronounced. Allergies! Advice?

Fillers are temporary and may not give full correction in older patients. Blepharoplasty may be a better long-term solution.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 63 reviews

Lower lid bags

Thanks for your question. I always like to evaluate the etiology of the lower lid problem if possible. If you experience seasonal allergies (seasonal runny nose, itchy eyes, sneezing, nasal congestion, etc) then getting allergy tested may be a great idea- if this is the problem treating the allergies will help the under eyes and you win!

The fillers vs. surgery question is largely up to you. I do think that a filler would be a great option to smooth out the under eye area and save surgery for a couple more years. 

Hope this helps!

Dr. Robb

Philip K. Robb Jr., MD
Evans Physician
5.0 out of 5 stars 4 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.