Non-surgical Treatment for Undereye Bags?

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

Doctor Answers 39

Under eyelid bags and dark circles can be improved

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.

Springfield Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Can undereye bags be treated non-surgically?

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
5.0 out of 5 stars 25 reviews

Lower eyelid fillers can help lower lid bags

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
5.0 out of 5 stars 22 reviews

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There is No Effective Non Surgical Treatment for Under Eye Bags

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

Restylane might help

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.

Non-surgical treatment for under eye bags

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
5.0 out of 5 stars 38 reviews

Undereye Bag Non Surgical Suggestion

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.


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 103 reviews

Under Eye Bags

This is a great question. With the development of less hydrophilic (attract less water) fillers such as Belotero, or even the new Restylane Silk, I would say that some patients may be able to temporarily disguise the appearance of their under eye bags. These fillers must be injected with extreme caution, and by a surgeon with experience in the periorbital region. The skin under the eyes is very thin and we have to be careful not to inject the fillers superficially as it this may worsen the problem. Some patients also have a higher affinity to attract water into area where the fillers where injected and it is hard to predict who will do this and who won't. If the technique is good, this is less of a concern.

In most cases, under eye bags are treated with a surgical procedure called blepharoplasty. This procedure can be done sometimes with an incision inside the lower eyelid and could be considered minimally invasive even thought in theory it is surgery.
The more commonly performed eyelid procedure, a blepharoplasty, will address the protruding under eye bags, the excess/crepey lower eyelid skin, and in some cases we can also use the same procedure to restore the mid face via fat transposition/fat grafting and/or a mid face lift. 

Make sure you see a surgeon that has expertise in aesthetic surgery of the periorbital region as this area requires a specific and detailed knowledge of the anatomy to ensure a good result. 

Hope this answer was helful. Good luck!

Lower lids

A difficult thing about lower lids is that they should not be approached in a "one-size-fits-all" format. There are many anatomic factors to consider and for each of these there are different treatment modalities. The tricky part is to decide which is/are best for your specific situation and how motivated you are to undergo the presented treatments.

There certainly are many non-surgical options, including chemical peels, injectable fillers, and laser resurfacing. All of them are very safe and can be extremely effective when used for the proper patients. Again, the key is using the right treatment(s) for the right patient.

Do some research and see an experienced board-certified oculoplastic surgeon with proven results. He/she will do a thorough exam and discuss specific recommendations/options so you can come to an educated decision on your treatment plan.

Kenneth E. Morgenstern, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

How can I fix my puffy, heavy, lower eyelid bags without surgery?

Lower Eyelid Bags can be caused by many different issues. Sometimes a combination of issues are contributing to the puffy, heavy look of the lower lids. Changes in skin, fluid accumulation, muscle, fat from the eye socket, and changes in the cheek and surrounding structures can all contribute. It is important to have an experienced physician evaluate your eyelids to determine all the changes that need to be addressed to achieve your goals. In many cases, in office procedures can be used to improved the shadowing and baggy appearance of the lid. I commonly use injections such as Restylane, and Voluma in combination with skin rejuvenation to improve the lower eyelids without surgery.

Jeffrey M. Joseph, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 7 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.