Is There a Way to Get Rid of Eye Bags Permanently?

I'm 30 years old and have had lower eye bags for as long as I can remember. The bags are present all the time even when I smile/squint. In the mornings when I wake up they look just horrible. But like I said I always have them.

I've had Restylane injections before, but they didn't last long and alleviated this condition a little bit. Please help me and tell me what to do. I'm really sick and tired of them. Thank you!

Doctor Answers 5

Eye Bags, Circles, and Demarcations

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There are many causes of eye bags. Some are shadow issues, some are discoloration issues.  It is good that you feel the Restylane made a difference. You should read and research fat transfer a bit. There are some really good aspects of fat trasnfer. We do a ton of it at our practice. 

Most people with this problem have a multifactorial issue meaning they have more than one problem causing this demarcation.

Below is a list of common causes and my treatment protocol. 

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat transpositioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and/or fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,

DrC


Chicago Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Permanent solution for eye bags

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Dear Shadi,

Lower eyelid bags that occur in younger individuals such as yourself is almost always genetic though infrequently fat protrusion as a result of weakening of the orbital septum (the structure that holds the fat back around the eye) can also occur. The fat around the eye has nothing to do with weight gain or weight loss.

The fact that Restylane helped you temporarily suggests that a permanent correction is possible. Tightening the skin with lasers, peels, or other forms of energy doesn't help the eyelid bags. Your options include either "masking" the bags by injecting a thin material such as Restylane around the puffiness and doing this on a semi-annual basis or smoothing the eyelid to cheek transition by removing or transposing the fat. In my practice, younger patients undergo a transconjunctival lower eyelid blepharoplasty with fat transposition. This entails making an incision behind the eyelid (no external scar) followed by mobilizing the fat and then 'moving' or transposing it to the hollow area below the puffiness allowing a smooth lid to cheek transition.

Patients are very happy with this 45 minute to 1 hour procedure that can be done under local anesthesia though I feel most individuals do best during the procedure with a mild amount of sedation to keep them comfortable.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Yes!

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Dear Shadi,

Fat that normally rests around the eye is contained behind a wall called the orbital septum. As one ages, this wall can weaken and the fat can bulge forward . Having lower eye bags at your age is usually an inherited trait, not from aging. Some people are born with more fat than others and this can lead to more prominent bags as well.

The simplest procedure to essentially have permanent correction of this is to remove some of the fat from the lower lids. A more technically challenging operation, (one that I personally prefer), is not to remove the fat but to move it. This is called lower lid fat transpostion. This preserves the fat and prevents a hollowed look to the eye that can happen as one gets older. For both procedures, the incision is inside the eyelid and thus not visible.

Ask a board certified plastic or oculoplastic surgeon which procedure would be right for you.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

Eye bag Treatment Options

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Thank you for your question about non-surgical treatment of under-eye bags.

There are many ways to tackle under-eye puffiness, lines, and/or dark circles.  There are some skin care products you can use.  Some laser treatments such as ErYag lasers can tighten skin under the eyes and help reduce fine lines.  Platelet Rich Plasma (PRP) microneedling can also tighten the skin and help promote collagen production.  Finally, you can camouflage under eye bags by placing fillers such as Juvederm Vollure or Voluma, or Restylane Defyne in the area.   

To be sure, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Eye bag treatment options

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Thanks for your question. There are multiple options to treat under eye bags ranging from minimally invasive office procedures to aggressive surgical procedures. The treatment that is best suited for you will depend on a face to face examination with a qualified surgeon who can help guide you through the options. Your selected treatment will largely depend on your expectations, the results you desire, the down time you have available, and cost. In the end I would encourage you to have a face to face evaluation with a qualified surgeon and be prepared to vocalize what you want in the categories I've listed above. Good Luck!

Talon Maningas, DO
Joplin Facial Plastic Surgeon

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.