What is a more permanent fix to these under eye bags when I smile? I'm 23 years old. (Photo)

I absolutely hate smiling sometimes because I have such large under eye bags when I smile. When I don't smile my under eyes are perfect, but the second I do I have huge eye bags. A lot of people I know don't have this problem and they don't have any bags at all when they smile. It really bothers me because I don't like how it affects my smile. I know there are fillers but they only last a few months? I want something that lasts longer. is that possible?

Doctor Answers 8

Eyelid Surgery

Thank you for your question. It is difficult to tell the extent of under eye bags based on your picture, however, based on your description, hydraulic acid fillers would be a great solution to create additional volume. There are techniques to combine with fillers to create a longer lasting remedy as well. suggest that you consult in person with a board certified facial plastic surgeon. Best wishes,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 94 reviews

Little bit of filler

The crease you are noticing is not a typical sign of aging. It is actually due to the position of your eyeball. The muscle that runs around your eye called the orbicularis oculi squeezes in a circular fashion when you squint. Without having examined you, I can only assume that your eyeball (globe) sits a little more outside of the eye socket. So when you smile and your orbicularis oculi contracts, it pulls around your eyeball and you can see the transition point between your globe and the bony rim of your eye socket. If your eye was set further into the eye socket, you would likely not see this crease. I remind my patients that this is not a sign aging, but for those who are still bothered by it, I place a very small amount of hyaluronic filler along the bony rim to smooth the transition between eye and bone.

Melissa Hu, MD
Houston Facial Plastic Surgeon

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

Fillers, lasers, surgery and skin care can all be done to help the under eye area improve.  I suggest a formal consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Muscles or eye bag lower lid when smiling

I have treated these with Botox or Xeomin with great results.  Expereince in doing this is a must.  Thanks for very good question

Afshin Farzadmehr, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

That's your lower lid muscle

Great question and thanks for the photos. You have a muscle around your eye called the orbicularis oculi it acts kind of like the string in a purse. When you flex the muscle (like with smiling) it changes from being flat and broad into more of a band. It's that band of muscle you're seeing below your eye. Check out pictures online of the muscle and it will make perfect sense!~Dr. Sieber

What is a more permanent fix to these under eye bags when I smile? I'm 23 years old

What you are seeing is the muscles of your lower lid flexing. That is normal and cannot nor should it be removed by any method

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews

Under Eyes

You do not have herniated fat pads (eye bags) of your lower lids.  What you see is some slight over-active orbicularis muscle (runs across the lower lid). You do not need surgery for this.  Your eyes look nice when you smile.

Barry M. Schwartz, MD
Weston Plastic Surgeon
4.0 out of 5 stars 4 reviews

Patients would LOVE your eyes!

Good morning Ariel.You have beautiful eyes that most people would love to have! When you smile, your orbicularis oculi muscle contracts (everyone's does), and this is what is creating the small area of fullness under your lashes. It is actually a beautiful sign of youthful lower eyelids. I would urge you to embrace this sign of youth (I know it may be difficult for you to see it that way) as you live in your youth. I'd steer you away from doing anything about it, because the effects of doing something may leave you wishing for that youthful fullness that you don't like at this time. :)Hope that helps!-Dr F

Carlos Farias, MD
Chicago Physician
4.1 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.