How can I get rid of under eye bags when I smile? (photos)

Whatever you do, be careful since you have prominent protruding eyes and that has greater tendency of problems with lower eyelids getting pulled down. There are several options, each with different pros and cons. See website link.

I WOULD TRY FILLERS BEFORE GOING IN AND DOING SURGERY , THE DIFFERENCE BETWEEN FAT TRANSFER AND FILLERS ARE FILLER ARE LESS INVASIVE AND CAN LAST 6-9 MONTHS SOMETIMES UP TO A YEAR DEPENDING ON WHICH ONES. FAT TRANSFERS ARE USUALLY SURGICALLY DONE WITH LIPO AND TRANSFERRED TO ANOTHER AREA OF THE BODY. A FAT TRANSFER CAN ALSO BE DONE THROUGH A LOCAL AFTER SURGERY FOR A REPEAT FAT INJECTION. FAT INJECTIONS OR TRANSFERS ARE USUALLY MORE PERMANENT. THIS IS SOMETHING THAT YOU MAY WANT TO SPEAK TO YOUR DOCTOR ABOUT IN A CONSULTATION AND SEE WHAT YOUR OPTIONS ARE.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

On you lower right eyelid there are 2 bulges, one is from the contraction of the orbicularis muscle, just like on the left and the lower bulge is likely a fat bag. You need a good exam to assess the degree of bulging from the fat bag to see if it would be worth correcting it with a trans-conjunctival blepharoplasty. Also a lower eyelid surgery could thin out the orbicularis muscle to make the bulge less prominent. Non surgical options would only help temporarily, like Botox with a small dose to decrease the bulging of the orbicularis muscle. Good luck

Thank you for your question.  Based on your anatomy, treatment for your situation can be tricky, and I would recommend a conservative approach, if any.  See a specialist to become more educated about your options and best wishes.  

Thank you
for your question. Surgery for conditions like this is probably the gold
standard. It appears that your pre-tarsal orbicularis muscle is hypertrophic
(big lower eyelid muscles). Often, surgical excision through an eyelash
incision is the best way. However, some doctors have reported success by doing
ThermiTight when patients wish to avoid surgery. Only a few Thermi doctors do
this procedure. I have had the privilege of teaching and performing this
procedure since the beginning. A ThermiTight procedure may improve your situation
somewhat if it targets the connective tissue but it doesn’t appear that you
need fat removed. This would avoid scarring and does not preclude a surgical
procedure later. Good luck!

Hello and thank you for your question. Many patients have similar concerns regarding how to address lower eyelid bags. Fortunately, there are many products and techniques available to help. The core of a treatment regimen is your daily skin care plan. From there, you will graduate to injectables (e.g., botox, juvederm), skin resurfacing (e.g., laser, RF), and ultimately to surgery (if needed). I suggest that you seek evaluation for a lower eyelid lift. Of course, you will need an in-person consultation to evaluate you for these procedures. Preoperative visualization with the Crisalix system may help with your decision. Your treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 
Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon