What can be done to remove my under eye bags and make the lids look more symmetrical? (Photo)

Ideally you find a surgeon who does this work under light intravenous sedation administered by an anesthesiologist or nurse anesthetist. There is no substitute for a detailed in person examination. I strongly recommend finding an oculoplastic surgeon who offers transconjunctival arcus marginalis release. The eyelid surgery is performed from behind the eyelid rather than through a skin incision below the lower eyelid lashes. A dissection is performed and the fat pockets are rotated to the onto the cheek bone and sutured there. This flattens the fat bulges and improved the groove under the eyes. Don't get talked into a lower eyelid skin incision. Hope this helps.

Under eye bags are treated with blepharoplasty surgery. I perform this in a scarless form when patients don't have extra skin around the eyes and only need the contours improved. Volume loss around the eye is a big component of peri-ocular aging and fat transfer is combined with blepharoplasty procedure the majority of the time. General anesthesia is not necessary for this procedure and I routinely perform lower eyelid blepharoplasty and fat transfer under IV sedation with an anesthesiologist. Patients don't remember any part of the surgery and have faster healing and resumption of activities. I would recommend you seek a consultation with a facial plastic surgeon that performs these procedures on a regular basis.

You would benefit from a brow lift. This will lower your hairline, decrease the vertical height of the forehead and make the eyebrows more symmetrical. This will help with the upper eyelid skin. You have excess skin of the lower eyelids. You would benefit from a lower blepharoplasty and the fat would be transposed to decrease the sagginess and fill out the tear troughs.

Best Wishes,

Gary Horndeski, M.D.