Should I consider blepharoplasty or fillers? (photos)

I have always had this problem under my eyes since childhood, now that I am older (20) people comment on it. They often ask if I am tired or sick. The reality is, I am really quite healthy. As you can see I have a deep set line near my tear tough to the top of my cheek, its my biggest insecurity. I just want my under eyes to be crease and bag free. I want to look wide awake and young. Wondering what avenues I should start looking into for solutions to this problem.

Doctor Answers 11

Fillers or Blepharoplasty in 20 Y/O

Treating under eye tear trough in younger individuals are best treated with fillers, not blepharoplasty. This has to be done properly by an expert in treating the area with the proper product like fat, Juvederm Voluma or Radiesse. (See or

Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Age 20 Should I consider blepharoplasty or fillers?

I would think that the use of fillers should be your first treatment choice.  Relatively very safe and easy and usually very effective without the need for surgery.  Meet with an board certified surgeon for a face to face exam, but based on your photo and your age I 'd think of filler (hyaluronic acid).  Best wishes.

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Should I consider blepharoplasty or fillers?

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary hyaluronic acid fillers like Restylane, long-lasting micro-fat grafts, and blepharoplasties. There is no one best procedure. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

Temporary filler of Restylane is a reasonable approach for a patient with your particular anatomy and age. Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Fillers vs Blepharoplasty

Hi there,

You might be surprised at what a common question this is. Creases, shadows and bags around the eyes can come from a number of different sources.

Often when a person is young, these shadows are a family trait seen across the ages. Because the causes can be different, you can imagine the treatments can be different too.

In your case additional photos would be helpful and a face to face consultation would be imperative. However, it is likely that you will be a candidate to consider different options.

Fillers - usually Hyaluronic Acid ("HA") are an excellent way to subtly reduce the shadows and fill in hollows that are the result of family characteristics, aging or both. These can be tailored to your individual needs, have little to no downtime and are reversible. One of their upsides is also their downside - they are not permanent. In this area of the face results can reliably last 12 or more months, sometimes as long as two years.

Surgery - a lower lid Blepharoplasty, would offer you a more permanent solution. In most people under 30 with little to no extra lower lid skin a Trans Conjunctival Blepharoplasty with fat transfer is likely a good option. In this procedure the incision is hidden on the inside of the lid so there are no visible external scars. There will be down time but the results are more powerful and will mature and change with you over time.

Visit a board certified Plastic Surgeon to get a more personalized view of what is possible for you.

Take care and good luck.

Dr Nodwell

Trefor Nodwell, MD
Ottawa Plastic Surgeon
4.4 out of 5 stars 10 reviews

Lower blepharoplasty for naso jugal groove

You can start with fillers in the naso jugal groove. For better and more permanent results, you need a blepharoplasty with skin removal and fat removal.

Should I consider blepharoplasty or fillers?


Thank you for your question. you are a good candidate for both procedures, i recommed you to do fillers and see the effect and results as you are still young then later if the situation does not improve you can do Surgical eyelid. 

Lower lid blepharoplasty or fillers...

Your most permanent option is blepharoplasty, however, if you have no down time, the filler is a nice temporizing option. A lower lid transconjunctival blepharoplasty would remove or transpose some of the protruding fat pad and give long term results. Surgical risks are small but should not be taken lightly. Juvederm Voluma XC injected into the pre-periosteal location along the zygoma would give you up to two years of enhanced contour. There are other fillers out there, but the hyaluronic acid fillers may be reversed if you are not pleased with the results. Be sure to consult with an experienced surgeon and injector - and get more than one opinion prior to scheduling a procedure. Best wishes.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Blepharoplasty or Fillers?

Thank you for your question.

Either a blepharoplasty or fillers would improve your appearance.  However, knowing which one is the best for you will require an in-person examination, and a discussion of the risks/benefits of each.  I recommend you consult with several plastic surgeons in your area to discuss your options.


Dr. Michael Epstein

MAE Plastic Surgery

Northbrook, IL

Fillers Are A Quick & Simple Fix For Tear Troughs & Under Eye Creases

Front face photos of both eyes as well as profile views of each would have allowed a better assessment. However, in general, from what I can see in the one side view provided, the use of fillers would be a quick and simple, relatively non-invasive and inexpensive approach to dealing with your problem. In my Upper East Side Manhattan practice, my choice for this region  is Belotero Balance, which possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially into the delicate tissues under the eyes. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would opt for Teosyal Redensity II for this purpose.)

Filler injections under the eys are an advanced injection technique and should not be left to the hands of medspas and novice physician injectors accustomed only to treating ordinary smile lines with simple Restylane. Be sure to seek consultation and treatment at the hands of a board certified, aesthetic core physician with experience and expertise in treating this region and make sure to ask to see his/her before and after photos before proceeding. Good luck to you.,

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 22 reviews

Eye issue

You would have to be seen in person to be properly evaluated. The lateral view does show a prominence that might benefit from a transconjunctival conservative fat removal or perhaps filler to camouflage the lid cheek junction.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.