Fillers or surgery for excess skin under the eyes? (photos)

What is the best way to get rid of the excess skin under my eyes? I have to constantly deal with people asking if I'm tired and it's even worse without make up.

Doctor Answers 4

Excess skin under eyes

It appears in your photos that you may have a thicker level of muscle that is normally present at that spot on the outer surface of the lower eyelid. It tends to worsen when a person is expressive (smiling, etc). Additionally when the eye itself is slightly forward, it creates a greater difference between this muscle/skin of the edge of the lower eyelid and the base of the lower eyelid. 

A conservative trimming of the lower eyelid muscle helps. No/very little skin should be removed since you don't really have loose skin. A filler in small dose can create a fullness and decrease the discrepancy thus giving balance. 


Baltimore Plastic Surgeon
4.2 out of 5 stars 5 reviews

Lower Eyelid Bags

Thank you for your question and including a photo.  I can't tell for certain, but I suspect that you are smiling in this photo.  It would be helpful to see a photo when you are not smiling.  When we smile, the muscle beneath the eyes tends to bulge, making this problem look worse.

I suspect that you would do well with some Restylane under your eyes.  However, you certainly would need a consultation with an experienced physician to help you decide what treatment is best for you.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 23 reviews

That is easy: Fillers!

You do not have "excess skin."  You have a very soft weakness under the eyes that will beautifully be handled by a small amount of hyaluronic acid filler.  I prefer Restylane for this.  Do not find the cheapest injector.  Please find the best injector for this treatment.  This is a fussy service.  Who does it makes a big difference.  Typically these treatments last well over a year and for someone with your issues, sometimes 2 years.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Eyelid surgery vs. Fillers

You appear to have a ridge of tissue under your lower eyelids, which is not necessarily a sign of aging. In fact, if you look at pictures of infants and small children, many of them have the same, usually muscular ridge. We do, however, want to minimize this. You appear to be quite young, so I doubt you have much in the way of loose or excess skin. This can be excised, but you have to be very conservative with this as too much excision can result in complications. Perhaps the best and least invasive strategy at your age is to soften the ridge with an injectable filler such as Juvederm.

Ben Lee, MD
Denver Plastic Surgeon
4.5 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.