18-years-old with eye bags - is surgery the only way? (photos)

While you can always try some filler in the tear trough to hide the bags, surgery is the only way to make it smoother for the long term. If undergoing a lower blepharoplasty to remove the fatty bags, I would also inject some fat in the tear trough at the same time to make the whole area much smoother. Be sure to see a facial specialist for consultation.

Eye bags and tear-through deformities frequently happen at younger ages in a group of patients who have small malar (cheek) bones; it is hard to say that for you since these photos do not show much of your face. Using transconjunctival lower blepharoplasty, with an incision placed inside of the patient's eyelid it is possible to correct the tear through and remove fat bags. Since you do not have any skin redundancy, there will be no visible outside scars. I have done this procedure on patients 19-20 years old with good results. Hope this helps.

You have excess fat creating the eyebags. The procedure would be a lower blepharoplasty which will release the fat, reposition and eliminate the fullness.

Best Wishes,

Gary Horndeski, M.D.

Based on your photo, it looks like a lower blepharoplasty would be the only effective method.

Best of luck !

The higher up bubble is actually your eyelid muscle (orbicularis) - this can not be removed. Your lower eyelid bubble is lower eyelid fat pad. This can be surgical removed. I would not recommend filler as it may make things worse. I would recommend surgical removal of the eyelid fat bag.

This anatomic area is somewhat complex and aesthetic issues need to be assessed very carefully.
In the ideal youthful face, the contour of the lower eyelid should be snug without showing bulging of the lower eyelid fat pads. Typically just below this area. There should be an abundance of fullness and volume.
With facial aging, we typically see the reverse. Typically in the aged face with a bulging of the fat pads in the lower eyelid because of weakness in the Peri orbital septum. Just below this, there is often loss of volume and with sometimes called the tear trough and the upper part of the mid face.
And some individuals the primary problem is the bulging of the fat pads in the lower eyelids, and then others. It is the lack of volume in the tear trough and the mid face.
And some people both are an issue. I recognize the desire to maintain anonymity, but to make an assessment we need equality for face pictures.
What’s the primary problem is bulging fat of the lower eyelids, then removing some of that fat is probably the correct procedure. Sometimes restoring mid face volume can help camouflage the protruding fat pads.
This area is complex and providers may have different opinions. Recognize the complexity, makes a good assessment difficult, and with that comes differing opinions.
In the end, the most important variable is to find the most skilled and experienced provider. There are different ways of approaching this problem, and recognize that there are not necessarily absolutes or one that is exclusively better than the other.
If you look at the website for Dr. David Mabrie MD in San Francisco you will see what can be accomplished using on the volume restoration using Fillers. dr. Mabrie is a facial plastic surgeon who is devoted his career working with using only facial fillers.
He has some of the best before and after pictures of anyone I’ve ever seen. I’m not suggesting everybody lied to San Francisco to have him do your fillers, but reviewing his results can work as a clear baseline for understanding what’s possible with the use a Fillers avoiding surgery. There are plenty of talented providers in our communities, but finding the right provider may be a bit of a challenge, and may take some serious effort.
There are both surgical and non-surgical options. To get a quality assessment we need better pictures or preferably an in person consultation.
This type of work is often done and by plastic surgeons, facial plastic surgeons, and ocular plastic surgeons. In the end, the background or training is probably not as important as the providers, skill and experience.The following are some general guidelines and recommendations to find the best provider.
Finding the right plastic surgeon.
One and a half months is not enough time to lose a substantial amount of weight if it's done in a healthy manner.
I'm going to include a write up that I did from my experience of seeing thousands of patients in regards to weight loss.
I personally lost 50 pounds in about eight years ago.
My write up his part for my own personal experience and party from interviewing patience.
Finding the right plastic surgeon is not easy.
I see medical professionals choosing surgeons they think are the best but in reality I only average.
The following are my recommendations for how to find a truly talented board-certified plastic surgeon.
Start with the website like yelp and write down the name of about 20 board-certified plastic surgeon's with excellent reviews and at least 20 reviews.
Next go to the following website and check for reviews on each of those doctors.Real self, rateMD.com, Vitals.com and WebMD.com
A Doctor Who has organic reviews meaning they have not been manipulated should have an equal distribution of reviews on all various websites.
A Doctor Who has many reviews on a single website but few reviews on the other website showing indication that reviews may have been manipulated.
Yelp is the most difficult website to manipulate so it's a good one to start with.
Many doctors will encourage their patients to write reviews for them.
This may or may not include incentives for the patients.
These types of reviews are not considered organic and in my opinion are manipulated.
I've seen businesses that of been open for less than six months have close to 100 reviews.
I know some of the most talented doctors who been in practice for over 20 years have two or three reviews.
Doctors have a strong presence on social media are good at social media. This has no correlation with their surgical talent.
One of the most talented facelift surgeons in the world lives in San Francisco.
He is often booked up for more than six months.
He does not even have a website.
Plastic surgery is a competitive field and many plastic surgeons have sophisticated marketing teams.
Once you've isolated 10 doctors who seem have an overall excellent reputation you should schedule several in person consultations.
Even if you really like the first doctor you meet you should follow through and go through all of the consultations.
If the consultation is performed by a patient care coordinator or sales person then be leery.
If it seems like commission sales and that's what it is.
How much time did the doctor spend with you?
Did the doctor give you a realistic expectations or simply tell you how great you're going to look?
Reviewing before and after pictures is very important.
A talented plastic surgeon that has extensive experience with liposuction should have at least 30 to 40 before and after pictures of liposuction cases.
Ask to see results that are average excellent and not so good.
Ideally you should ask to see 10 consecutive cases but it is unlikely he will be able to get that.
Price is important but there is little correlation to talent and price.
That said the doctors who give bargain basement prices are probably not the ones you want to go to.
Ask each doctor with their revision rate is.
Doctors or highly committed to getting the best results should have a low threshold for doing a revisions.
Doctors who claim they never do revisions are either not true patient advocates or not being honest.
Ask each doctor what your policy is for revisions.
Who pays for it?
If fairly common practice is the doctor will not charge for revisions but may ask the patient to pay for all or some of operating room or Anastasia fees if they're needed.
Review what each of the plastic surgeons offered and use your gut instinct of who to go with your gut instinct.
I hope you find it helpful.
Best,
Mats Hagstrom M.D.