Non-surgical Treatment for Undereye Bags?

Is there a non-surgical way to treat bags under the eyes? 

Doctor Answers 48

There is No Effective Non Surgical Treatment for Under Eye Bags

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Thank you for your important question.

Puffiness of or Bags Under Eyes is a structural problem caused by excess or herniation of eyelid fat bulging against the eyelid skin.

This fat must be repositioned and or removed to remove the puffiness or bag.

Do not believe ads that say a cream or laser treatment will remove puffiness or eye bags-they will not.

Fat injection and Filler injection such as Restylane can camouflage the problem but injections into the eyelid can be dangerous and should only be done by an expert who is familiar with this technique

Under eyelid bags and dark circles can be improved

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It is an excellent question.  Can "eye bags" on the lower eyelid be treated.  The eye bags are usually inherited and results from orbital fat herniating or outpouching below the skin of the eyelid.  The only way to completely fix this problem is through surgery.  Lower blephroplasty, in the hands of an expert, results in removal or repositioning of the orbital fat.  Excellent results can be obtained with an approach near the eyelashes.

Good improvements can be made by using cheek volumization, tear trough filler and resurfacing with carbon dioxide.  For a really nice improvement in the area, some patients would benefit from doing all of these procedures, but the problem can't be completely solved without surgery.

Michael H. Swann, MD
Springfield Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Fillers for undereye bags

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Dermal fillers such as Juvederm and Restylane are a minimally-invasive injectable treatment that can help improve dark circles and bags beneath the eyes. When injected, fillers can add volume to smooth out indentations. The skin in the eye area is delicate, so it is important to work with a doctor who has extensive experience treating the eyes with fillers. In some cases, surgery, which involves removing fat, adjusting tissue, and trimming skin, may be a more comprehensive way to reduce bulging. A plastic surgeon can determine if surgery is the better solution for your particular case.

Yael Halaas, MD
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 43 reviews

Restylane might help

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At 41, you might have early tear troughs making it look like you have buldging fat bags above them. It may be that rather than needing fat removed or repositioned, you could mask the tear trough very effectively with Restylane. I have had many patients with this and they have great non-surgical results that last a year or longer.

Can undereye bags be treated non-surgically?

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In some patients, filler underneath the area of the bag may smooth out the contour enough that surgery is not needed for correction. My preferred filler for this area is Restylane. Most patients will have swelling for 2-3 days, and some have bruising for up to a week or so. However, this is generally better than downtime related to surgery, and it is certainly less risky.

Many patients, however, will still have some suggestion of undereye bags after filler unless surgery is done to remove or reposition the fat that tends to herniate (or bulge) over time. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 41 reviews

Undereye Bag Non Surgical Suggestion

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Although blepharoplasty (eyelid) surgery is the only treatment that is long lasting there are a few things you can do that are of temporary help. Make sure you have an exam to make sure that you do not have weak eye muscles, ptosis, as your cause by an exam by a board certified specialist.

Lower lids: Ceramide creams for the lower lids which in minutes as they dry the clear membrane tightens the lower lid skin minimizing bags and wrinkles. This lasts from 4-8 hrs and can be reapplied as needed. Radiofrequency, laser and peels tighten the skin with minimal downtime. Fillers for fat transfer #lipoinjection, to the lower lid to fill in the cheek-lid depression that casts shadows also helps many.

For the upper lids, Botox in the crows feet area just below the brow will gently lift the lateral brow and lift a bit of the hooding on the side of your eye. This lasts about 3-4 months. Make sure you go to an expert injector associated with a Plastic Surgeon, Facial Plastic Surgeon, Dermatologist, or Ophthalmologist skilled in injections.


Lower eyelid fillers can help lower lid bags

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As on ophthalmic plastic and cosmetic surgeon I see people in the office every day who are bothered by lower eyelid bags.  Some people need surgery. However the majority do not.  We now have hyaluronic acid fillers that can, for the right people give the most natural improvement of lower eyelid bags.

Here is how it works.  As our faces age we lose fat in our cheeks and in the area right below the eyelid bags.  Fat that causes lower lid bags does not get smaller as we age.  When we are young there is a smooth curve from the lower eyelid down onto the cheek.  However as the cheek fat gets smaller with age the adjacent lower eyelid fat becomes more noticeable and looks like a bag.  In other words our face has hills and valleys. In the lower eyelid, often the hill is not getting higher, the valley beneath is getting deeper.  

That is where fillers like Restylane and Voluma come in.  The filler is injected in the office to replace your cheek fat smooths the transition from the eyelid to the cheek and effectively removes the bag.

Of course you did not provide a photo, so I can not say if this treatment is the best for you.  I would suggest an evaluation with a cosmetic surgeon who is experienced with lower eyelids to see what treatment might be right for you.  

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 26 reviews

‚ÄčThe short answer is yes!

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The short answer is yes! 

The longer answer is:

No two under-eye regions are alike.

The area around the eyes is one of the most unique and expressive areas of the entire face. Our under-eye region in particular gives away a lot about our emotional state, level of fatigue, and even diet! There are many ways to enhance the under eye region from simply increasing sleep, cutting down on salt, and sleeping with our head elevated. Creams, fillers, lasers, and surgery are also options. Because everyone is different, the treatment of the under-eye region must be customized for each patient.

There are absolutely ways to treat the under eye region non-surgically. Often, lower eyelid "bags" are not just the result of fat coming forward, but also volume loss in the cheek and at the eyelid-cheek junction, often called the "tear trough." This gives the appearance of a "hill" in the lower eyelid, a valley in the "tear trough" and another, often smaller, "hill" in the cheek. This anatomic configuration may lend itself very well to volume treatments, such as fat transfer and fillers. Surgery can also be used to "borrow" some of the eyelid "bags" to fill these valleys.

I find that customizing treatment--whether surgical or minimally invasive--is the way to go. A good oculoplastic surgeon must possess many ways of thoughtfully addressing lower eyelid "bags."

Ivan Vrcek, MD
Dallas Oculoplastic Surgeon

Non-surgical treatment for under eye bags

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The safest non-surgical treatment of under eye bags, dark circles and hollows are Hyaluronic Acid Gel fillers. This class of fillers includes Restylane, Belotero, Juvederm, Perlane, Voluma and others. They are all the same product, just made up of different consistencies (ie. density, thickness, flow, etc). Injecting these fillers should not be done indiscriminately without a true understanding of how they work or the differences in their biochemical makeup. It is this knowledge of the filler products that makes all the difference in outcome. Upon examination, I take a customized approach when treating patients, determining the best filler treatment plan based on their anatomical needs and personal aesthetic goals. Please make sure you find a board certified injector, as this is a very delicate area and needs to be treated by someone with a lot of expertise to give you safe and effective results.

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 54 reviews

Non-surgical treatment for under eye bags

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The peri orbital area can be complex as the concern can usually be related to either excess skin, muscle and ligament laxity, bulging forward of orbital fat and/or lack or bone structural support beneath the eye. Medical conditions like allergies, thyroid and inflammatory conditions can also can contribute. Any medical conditions should be treated first.   Depending on the situation, mild skin tightening can be accomplished with chemical peels, lasers and micro needling and other non surgical devices. Hydration and volumization to add support of the tissues can be accomplished with good skin care, PRP injections and fillers.  Fillers must be carefully selected and performed  in this area though.  In more advanced cases, a  variety of surgical procedures can help. Be sure to consult with a qualified physician who is experienced and takes a comprehensive approach.

Stephen Fink, DO FAOCO
Newport Beach Facial Plastic Surgeon
4.7 out of 5 stars 13 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.