Severe under eye bags and wrinkles at 23? (Photo)

Question

Any idea why my bags look like this at such a young age? What procedure/lifestyle changes can I practice to get bigger, less puffy and less wrinkles eyes?

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) 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, lasers, microneedling/PRP, cosmelan peels, 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Dark under eye circles can make you look tired and older than you are. I would use a combination protocol that includes topical Melarase creams first, followed by a combination of injectable fillers, fractional laser, and RF to blend out the eyelid hollowness and tighten the skin. 
Recommended Creams: Melarase Brightening Kit
MelaClenz
Melarase AM
Melarase PM
Melapads
Replenish Retinoid Cream
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

Under eye bags are caused by depressions in the area and can be permanently corrected with surgery or temporarily camouflaged with fillers.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eyelift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression.
I hope this helps!

Adam Scheiner, MD · Answer

Dear NY,It appears from your photos that you have a few issues affecting your lower eyelid region. First there are wrinkles in the skin when you smile and I assume also at rest. Second, its difficult to see from this one set of photos but you may have some fullness in the lower eyelid region at rest. This fullness usually occurs with age but at times can appear in younger patients as well. These condition can combine to make a person appear tired, sick and older even when they feel fine inside. For the smile lines, Botox or Xeomin or Dysport could be used carefully to soften those lines when you smile.For the skin quality issues, procedures that cause the skin to repair itself are suggested. For the fullness that might be present, eyelid surgery to remove or relocate the fullness here could be helpful.Best to seek out a specialist in your area. I hope this helped.

Elham Jafari, MD · Answer

Hi and thank you for your question! Bags and dark circles under eyes can occur even at very young age due to genetic predisposition, etc. While some life style choice might make them look more prominent, the impact is often minimal. We can make the bags and dark circles less noticeable by injection of hyaluronic acid fillers under the eyes to make a more uniform and balanced transition to cheeks and other areas nearby. I recommend cannula technique. I hope it helps and good luck!

Adam Goodwin, MBBS, FRCS(Plast) · Answer

So when we smile, everyone gets lower eyelid wrinkles. Even small children. This is because the skin here is the thinnest on the cheek and so crease readily as we smile. There are a number of non surgical treatments that can help ticket the lower lid skin or stiffen it so that it doesn't wrinkle quite so readily but you are too young for surgery. Hope that helps Adam Goodwin

Ivan Vrcek, MD, FACS · Answer

Thank you for your photo and question.
I do see the changes in your lower eyelids that you are describing in your question. There are some lifestyle changes including sunscreen use, more rest, and decreased salt intake that can help some.  This is a very common situation, and if you find that lifestyle modification is not enough, you appear to be a great candidate for a small amount of filler to add some volume to the under-eye region. This will help to camouflage the eyelid-cheek transition and fill some of the "hollow" area along the upper part of the cheek bone near your nose (often called the tear-trough). A small amount of botox could also be used to soften some of the lines and wrinkles that you are seeing along your lower eyelid as well as decrease some of the fullness just below your lashes (this are is called an orbicularis roll).
I recommend seeing an eyelid specialist (oculoplastic surgeon), to treat this delicate area. Dr. Brett Kotlus is in New York, and is very experienced in this area.
Best of luck!

Camille Cash, MD · Answer

The look of your eyes will be heavily influenced by your genetics.  There are things that you can do to help the area.  Some include getting plenty of rest, use sunscreen every day, don't smoke, and drink plenty of water.  Treatment options to consider include fillers, Botox, chemical peels, or microneedling to help improve the area.  I recommend meeting with a board certified plastic surgeon in your area to learn what is best for you.

Justin Harper, MD - Account Suspended · Answer

Hi newyourkgurl78,First of, let me assure you that you are not alone. A lot of our clients in their 20s suffer from undereye circles and hollows which create a gaunt and tired look. This usually happens to people who are older because of the slowdown of collagen growth, loss of fat and bone resorption - BUT it can happen when you are young, as well. Sleeping too much or too little can make this worse. Ditto eating a lot of salty or sugary food. However, genetics play a crucial role.
I usually inject a hyaluronic acid filler like Restylane Refyne into the tear trough area (your problem area). It works like a dream because you see the improvement immediately. It is made using XpresHAn Technology which promotes a "natural look"  and can last between 6 months to a year. Volbella can also be used and another Juvederm product, Voluma can last longer. For excessive darkness even after filler injections, laser is a good option.You can try Vitamin C or other eye brightening undereye cream or serum. Last but not least, remember that photo damage from unprotected sun protection causes fine lines and wrinkles.I hope this helps, Justin Harper, M.D.

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