Should I get a blepharoplasty for the bags under my eyes? Very concerned with it not look natural (Photo)

Hello!First of all thank you for your question.Regarding the photos it looks like you are a perfect candidate for lower eyelid blepharoplasty! You can get rid of the extra skin, it will give you a fresh look.

Hi @Warmhearted304990. Thank you for sending your photos--you are a great candidate for a transconjunctival lower blepharoplasty. The fat pockets are prominent and you should have very natural results when performed by an experienced plastic surgeon. Best of luck, Dr. Nima!

Hello! Thanks for your question.For the lower lid surgery we are focussed on improve and restore the youthful appearance. Clásico blepharoplasty techniques were based in an excisional philosophy, removing fat from the bags and skin, sometimes getting unnatural aspects (hollowness like a cadaver). Contemporary techniques are based more in tissue preservation. We remove some fat from the bags but not all and part of that date is repositioned for improve the lid,-cheek union. Sometimes with the same bag fat sometimes with fat grafting injections, the skin removal is reserved for patients with extra skin. Usually younger patients don't need skin removal and all the procedure is performed by an incision inside the lower lid (transconjuctival approach) therefore no visible scar. The result of doing this properly is a natural, and lasting result.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

It appears that lower blepharoplasty done through an incision inside the eyelid, transconjuctival, would be a good procedure to address bags under your eyes. Most likely, you do not need skin excision. Good luck.

Before jumping into expensive, aggressive surgeries that entail significant downtime and risk scars, you might wish to explore the use of robust under eye HA fillers, which have been used for decades for purposes, such as treating tear troughs, under-eye hollows and bags. Volumetric loss in the cheeks (which serve as a major structural support for the infraorbital area) that comes with the passage of time is a significant contributor to the aforementioned problems. These can be ameliorated when volume is restored with the appropriate filler using the proper injection technique. I have personally been performing this nonsurgical approach for well over two decades with gratifying results. Hope this helps.

This can be addressed beautifully with a lower eyelid surgery. The best option here is transconjunctival lower blepharoplasty with release of the lower eyelid fat into the top of the cheek. This work is done under light intravenous sedation from behind the lower eyelid, so no skin scar. The pillow of fat in the lower eyelid is mobilized and advanced under the tear trough hollow as a living graft. Alternatively you could have under eye hyaluronic acid fillers to smooth the grooved between the lower eyelid fullness and the top of the cheek. Both services are reliable but filling with hyaluronic acid filler is an office service, non surgical. The only filler for this application in my opinion is Restylane. Who you go to for these services makes all the difference. Do not get talked into fat grafting. This is a terrible service for the top of the cheek. It causes unexpected scaring in the delicate glide planes at the top of the cheek and is irreversible. This causes unexpected ridges at the top of the cheek when you smile. Don't do that to yourself. A trichloroacetic acid peel at the time of under eyes filler or eyelid surgery will help reduce the pigmentary changes in your cheek which are likely related to past sun exposure. Your eyes can be your best feature.

Based on your photos, I would say that you do appear to be a good candidate for lower blepharoplasty. This procedure can directly address the protruding fat that is causing the bags.

It looks like you are a candidate for a lower blepharoplasty. This procedure is very useful when it comes to get rid of under eye bags and would likely help you in your case. Good luck !

I think you'd be a great candidate for a transconjunctival lower blepharoplasty. The fat pockets are very well-defined in your situation and you should have a very nice and natural result when done by an experienced surgeon.