What is the best solution to eliminate my eye bags and dark circles? (Photo)

I've had dark circles around my eyes since I was a child, and bags for the past 12 years or so. I am 39 years old. Concealer helps a bit circles, but when it wears off, I've been asked if I have a black eye. Embarrassing! I've tried everything to eliminate the puffy bags, but I realize now that they're likely hereditary. I always look tired and worn out, even when I'm well-rested. I would love a permanent solution that does not leave visible scars or impair my vision. What would you suggest?

Doctor Answers 6

Under eye concerns

The condition you have is likely genetic.  Some options for you to consider are fillers placed in the more hollow areas to smooth the overall look.  Lasers and microneedling (Skin Pen) are also helpful in improving texture and appearance of the under eye skin.  Lower lid surgery is a more permanent option that would surgically smooth the fat under the eye and remove excess skin.  Speak with a board certified plastic surgeon in your area to learn more.


Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Under Eye Rejuvenation with fillers, lasers, microneedling/prp

Yes, the dark bags you have are genetic and can be treated with lower eyelid surgery or fillers, lasers, and microneedling/PRP. 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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Lower Eyelid Rejuvenation

Thank you for your question. This is a very common, hereditary condition. While fillers can help, they are a temporary fix. We can now use a laser to make an incision from the inside of your eyelid to sculpt out the fat. This is done without a skin incision. It is a short procedure with life-long benefit. You should see a surgeon who can do computer imaging for you. That way yo can see what is realistic based upon your anatomy.

Best wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 27 reviews

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Lower Lid Blepharoplasty

Hi lilac7,

The "bags" or "dark circles" that are present around your eyes in the picture are the result of orbital fat (which is present in all people) that has begun to prolapse or sag as you have aged.  Orbital fat is not like other fat in the body which can be gained or lost.  Your two treatment options (for which you are a great candidate) would be:

1) Fill in the so-called "valley" (depression below the fat which is resulting in the dark shadow) with hyaluronic acid based fillers.

or

2) Surgically correct the prolapsed fat with a lower lid blepharoplasty in which the orbital fat is repositioned through an incision INSIDE the eye (no visible scar) in order to provide a smooth transition from the eye to the cheek and eliminate the dark circles/bags.

Best,

Dr. Paquet

Christian Paquet, MD
Beverly Hills Physician

Smooth cheeks for the holidays

There are many causes of eye bags. Some are shadow issues, some are discoloration issues. You need a good physical exam and facial analysis. I would bet you have a combination of the below. Most young patients with this issue have some aspect of eczema and some aspect of a prominent nasojugular ligament which gives a clear demarcation to the cheek/eye junction. A youthful face has a smooth transition from these subunits. 

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat re-positioning. 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. Fat transfer, which is permanent is very useful for this. Some patients require a mid face lift. 

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


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Lower lid "bags"

You have some prolapsed orbital fat in the lower lids which creates a shadow in the tear trough.  You have 2 good options for helping this: 1.  HA filler such as Restylane to the tear trough.  This smooths out the area so you don't see the fat pads.  2.  Lower lid blepharoplasty with fat repositioning.  This moves the fat down into the tear trough from an incision on the inside of the lid to smooth out the area.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 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.