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.