Help! I hate my eye bags, which procedure do you recommend? (Photos)

Question

I'm a virgin to cosmetic procedures so am very nervous to take this step! as I enter my 30's, I've noticed deeper under-eye hollows that make me look sad and tired. I'm shopping around for affordable, natural results by a professional so I can make changes to feel better in my skin. Which procedure do you reccomend/would help me best and what is the general cost?

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.

Nima Shemirani, MD · Answer

Hi @Versatile374327. If you are looking for non-surgical solutions, I would recommend either tear trough filler or PRP injections.  PRP which stands for Platelet Rich Plasma is a natural and non-surgical solution to treat under eye circles and bags. PRP is highly effective for restoring sunken eyes.  Generally, two vials of blood will be collected from the patient and placed into a centrifuge. The centrifuge spins and separates the platelets from the rest of the blood components. The plasma contains the valuable collagen and growth factors from the rest of the blood's components. The plasma is then drawn up into a syringe and injected in the tear trough area. Typically, 3 sessions is adequate for optimal results.

Mehryar (Ray) Taban, MD, FACS · Answer

Yes you are candidate for scarless lower blepharoplasty (transconjunctival technique with eye fat bags repositioning). See an expert.

Timothy Osborn, MD · Answer

I would recommend a fat transfer. More likely than not, buccal fat can be removed from your cheeks (which many people benefit from by reducing cheek fullness) and is tunneled up to under your eyes. The discoloration under your eyes is due to lack of volume, which can be improved by adding some back. Buccal fat does extremely well being transferred, and the entire procedure is done through the mouth, which means no external scarring!

Nelson Lee Novick, MD · Answer

I have written about this extensively many times before. The upper cheek region immediately below the under-eye area is a major support to the under-eye area. When there is significant volume deficit in this region, as appears to be the case here from the photos provided, this results in the secondary development of tear troughs and infraorbital hollows immediately above. A first, and often the most important step to take to rectify this, is to revolumize the uppermost portion of the upper cheek area, which, by itself, often gives rise to a significant improvement in appearance. This is something that in the hands of an experienced, board certified cosmetic dermatologist injector should take no more than about ten minutes to perform with immediate, on the spot, results.  Following this, if still necessary ( but often not), a cohesive, low viscosity HA filler may then be used to further improve the tear troughs. Fees in the NYC area may range from 775 to 1500 for the treatment. What would not be prudent is to be "shopping around."  The under-eyes are no place to be left to Groupon shopping for inexperienced, novice injectors. Make sure to consult with an experienced, board certified cosmetic dermatologist physician and be certain to check out his/her before and after photos of the under eyes before agreeing to proceed. Best of luck.

Camille Cash, MD · Answer

Filler is a great, cost effective option to improve under eye concerns for many patients.  The treatment is done in the office with the results lasting approximately a year depending on the filler selected.  With HA fillers you can dissolve the product if you are unhappy with the results.  If you are wanting more permanent results you can consider surgical procedures.  See an expert injector for treatment.

Leonard Grossman, MD · Answer

Even though the photographs submitted are not exactly optimal, it appears that you have a hereditary condition, which is inherited generally from your father’s side of the family. The lower eyelid bags are actually bone as you can tell by touching it. The easiest and the safest, as well as the most natural way to get rid of those bags is with fat grafting. When fat grafting to the lower eyelids and cheeks is done by an expert fat grafting plastic surgeon, the results are extremely natural and permanent. I hope to soaps and good luck from New York City Plastic Surgery.

Robert T. Buchanan, MD (retired) · Answer

You have, from the pictures, what appear to be classic tear trough deformities. If so, these are easily treated by filling deep on the bone or muscle under the orbital ligament. Unfortunately, a great majority of injectors will treat this with a lighter filler, superficially above the ligament. This method has a high complication rate and is one of the main reason so many people wind up having their filler dissolved. Also unfortunately, the correct filler is more expensive. This should take at least 2 ml of Juvederm Voluma or Radiesse which is abut $2000, though it may take more.

Help! I hate my eye bags, which procedure do you recommend? (Photos)

Answers (8)

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