Would a lower blepharoplasty target under eye circles and discoloration? 24 y/o (photos)

Question

I am 24 and have had under-eye circles/discoloration since I was a teenager due to genetics. I am considering a lower blepharoplasty to help fix this problem. Do you think this would be a good idea?

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from your photo you have puffy under eye. For get rid of this image and gain more fresh, elegant look I recommend you lower eyelid blepharoplasty. It would be more convenient to decide with face-to-face consultation. Best Regards!

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may benefit from dermal filler injections to treat the under-eye circles you’re referring to. These hyaluronic acid formulas can diminish under-eye circles by filling in hollow areas and creating a more seamless transition between the lower eyelid and the upper cheek area. While filler treatments are not surgery, they do require a great deal of skill and precision to achieve the best possible results. In my office, we use a microcannula to inject this area, which minimizes bruising and swelling and ensures the smoothest outcome. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can assess your concern and determine the best treatment to help you achieve your aesthetic goals.

Donald B. Yoo, MD, FACS · Answer

To create a more youthful look with a smooth eyelid to cheek transition, transconjunctival lower blepharoplasty is a great option. An in-person exam would provide a more accurate diagnosis, but preliminarily based on your photos it does appear you have pseudoherniation of fat creating "eye bags.” They should also be more prominent when you look up. If you want the best idea of what is possible for your eyes, do your due diligence, find an experienced surgeon, and have him/her evaluate you in person and discuss your options. @drdonyoo

Andrea Lora Kossler, MD, FACS · Answer

Thank you for the photos. The dark circles you notice are mostly due to the bags under your eyes causing shadowing, resulting in the dark circle appearance. The bags are due to fat herniating forward. A transconjunctival (no visible incision) lower lid blepharoplasty with fat transposition can reposition the fat into the dark circle to smooth out your eyelid-cheek junction. I recommend this over fat removal since your eye is slightly more prominent than your cheek (we call this a negative vector). Removal of the fat would make your dark circles look worse. Repositioning the fat is preferred. Other options you may hear about are filler or fat transfer. Fillers would help a little to camoflauge the dark circle, however the bag appearance would persist. In my opinion, fat transfer alone is not a good option, but could be considered if combined with transconjunctival lower lid fat removal. I think this is a step too much and you would do best with lower lid blepharoplasty with fat transposition.

Robert T. Buchanan, MD (retired) · Answer

I think under a blepharoplasty would be a horrible idea for you. You do not have excess skin so you absolutely should not have any skin removed. Releasing the in for orbital ligament and moving the fat pad also will not fill the area you desire. Because your problem is basically congenital, The best option is filling the area. By a true expert, fat works exceptionally well. However, I have switched to use of Voluma placed on the bone above the muscle below the orbital ligament to correct problems like yours. This also requires a true expert. Unfortunately, about 90% of the injectors out there use the wrong filter in the wrong location. Be very careful with who you choose.

Would a lower blepharoplasty target under eye circles and discoloration? 24 y/o (photos)

Answers (6)

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