What is the best option to remove this tired look from my face/bags for young woman? (photo)

I'm 33 and have bags that make me look older than what I am and make me look tired all the time. In my 20's, a good nights sleep would make me look refreshed in the morning, but that doesn't work anymore. Fortunately, my bags are not too dark as you can see from the pictures, but even when I put on make-up (pic with pink hoodie), you can tell that I have bags (and that's with foundation, corrector, AND concealer). What are my best options? Lower lid surgery?

Doctor Answers 11

Lowerlid eyelift #eyelift #blepharoplasty

The best way to correct fat pockets underneath the eye is with blepharoplasty surgery, commonly referred to as a lower eye lift.  The surgery is quick and minimally invasive and will leave you looking rejuvenated.  Many surgeons can do this in their office with just a local anesthetic.  Choose a board certified plastic surgeon who specializes in blepharoplasty.

Bay Area Plastic Surgeon
4.7 out of 5 stars 14 reviews

Options for "Tired Eyes"

There are several different options for refreshing the lower lid area. Many patients who are bothered by fat pads (bags) under the eyes benefit from blepharoplasty to remove them, and in your case it may indeed be possible to accomplish this through the lower lids, leaving no scar. It is possible that fat injections or dermal fillers could plump up the area and help you avoid eyelid surgery for a time, and it's also possible that the best choice would be to remove the fat bulges through eyelid surgery and add fillers to your tear troughs. A chemical peel could be an option for smoothing fine wrinkles and lightening dark circles.

As you can tell, an in-person examination and discussion with a board certified plastic surgeon is a must! Since there are a few different options, you and he or she will want to talk through your concerns and goals and decide what makes sense for now and into the future. Choose someone who has extensive experience in blepharoplasty and related procedures and who obviously enjoys helping patients with this delicate, sensitive area.

Elliot Jacobs, M.D.
New York Plastic Surgeon

Elliot W. Jacobs, MD
New York Plastic Surgeon
4.5 out of 5 stars 35 reviews

Fillers Work Well And Quickly For Masking Lower Lid Bags

Many of the changes we typically encounter in the lower lids with the passage of time--namely tear trough deformities, hollows and bags, result from shrinkage, shriveling, and a downward descent of the once robust, heart-shaped fat pad that sat immediately under the lower lids and extended out toward the temples, inward toward the root of the nose, and downward about half-way to the angles of the mouth. Although these changes are most often seen after age forty, genetic factors and a history of cigarette smoking and sun exposure may hasten the onset of these problems. 

The loss of this volume and its downward displacement in the direction of the jaw (due to weakening of the supporting ligaments and the downward pull of gravity) elongates the lower lid to several times its narrow youthful width and leaves it somewhat sunken. In addition, like a balloon having lost its air after being fully inflated for a long while, the skin of the lower eyelid fails to snap back to its youthful smoothness, and instead remains crinkled and baggy.

Today, we can address these problems nonsurgically with the injection of fillers and volumizing agents to restore the volume to the lower lids and recontour them, and mask the bags. A variety of have been tried for these purposes. My personal favorites for dealing with tear troughs--for providing overally smoothness, shape and lift-- are the recently approved Belotero Balance and Restylane L.

In my experience, while more prominent bagging may be improved considerably with this approach, some degree pf bagging typically persists following treatment. On the other hand, for mild to moderate bags, it usually takes about five minutes to treat each lower lid with immediate that typically evoke a "Wow!" response from patients when they look in the mirror.

While minimal bruising, tenderness, swelling and redness may occur following treatment in this delicate region, these are usually temporary and disappear spontaneously within one to seven days. Most people can return to work or social activities immediately or the following day and coverup may be used if desired.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

What is the best option to remove this tired look from my face/bags for young woman? (photo)

You could certainly benefit from a trans-conjunctival blepharoplasty (no external incision) to remove the fat bags, but another minimally invasive option could be filler treatment to the tear trough and perorbital area.  With micro-cannulas this can be done with minimal bruising and swelling.  You should seek consultation with a surgeon with specific expertise in facial aesthetic surgery.  Best of luck.

A. Joshua Zimm, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

You may not need lid surgery at all!

Thank you for the question and the photos. As we get older we lose fat from our face. You seem to have lost fat from under your eyes. So you may benefit from fillers to give you the rejuvenated rested look. 

And that would only take 10-15 minutes. Make sure you see a Board Certified plastic surgeon who can help you with that. 

All the best ...

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 69 reviews

What is the best option to remove this tired look from my face/bags for young woman?

You have lost volume under the eyes and hence the eyelid fat looks more prominent.
You can either have a trans conjunctival blepharoplasty to remove fat or have Dermal Fillers injected to fill the under eye hollows. In either case you should seek a person with expertise in doing both
All the best

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 74 reviews

Bags under eyes

Metsfn4life, I would recommend a "SOOF lift blepharoplasty". There is no question in my mind this is the best appoach for the majority of lower lid surgery patients. Good luck!!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Lower Eyelid Bags

Based on your pictures alone, you are a good candidate for a subconjunctival blepharoplasty (no external scar) to remove the fat pads (bags) in the lower lid. A TCA chemical peel of the eyelid skin would tighten the skin. The cost in my NJ practice for this produre is $3500, which includes a double board certified plastic surgeon with over 20 years of experience, a board certified anesthesiologist, and a Medicare approved surgicenter. The surgery takes about 45 min. Consult a Board Certified Plastic Surgeon Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 22 reviews

Tired look

A tired look that stems from pseudoherniation of the lower eyelid fat pads would improve with transconjunctival blepharoplasty. However, creepy skin can be improved with a laser or fillers. 

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Lower lid blepharoplasty

From the photos, it looks like you might benefit from a trans-conjunctival lower lid blepharoplasty. You need to be seen to know for sure, but this is a common procedure in young patients with lower eyelid bags. There are no visible scars and the recovery is rapid.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.