What procedure would improve the appearance of my under eyes? (Photo)

Question

Blepharoplasty? Fat transfer? Having a hard time pin pointing what I should ask for. My under eyes are aging me

C. Blake Perry, MD · Answer

You would be a good candidate for lower lid blepharoplasty with fat transposition. This surgery utilizes an incision on the back of the lid and moves your natural fat to fill in the hollow tear trough. This will restore the natural volume to your cheek and get rid of the “bag.” Best to see an eyelid expert.

Andrew Miller, MD · Answer

A transconjunctival eyelid procedure will remove some fat without the risk of lower eyelid retraction. Then fat harvest and injection can smooth the tear trough and creases under the fat pads. Finally, a little laser can tighten the skin under the eyes. Be sure see a facial specialist for consultation.

Chet Mays, MD · Answer

Thank you for submitting your question and including photos! A lower bleph is a procedure done under general anesthesia that will decrease under eye bags by removing excess skin/fat. Fat can be transferred as well to the cheeks and tear trough area to add volume as there is natural volume loss with aging. I would recommend consulting with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals!

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Anya Costeloe, DO · Answer

Thank you for the photos and your question. I frequency see this in my practice. Based on your 2 photos, it looks like you have under eye bags due to herniated fat pads as well as a deep tear trough. I would recommend a transconjunctival lower blepharoplasty with fat repositioning or fat grafting with under eye laser resurfacing to improve skin texture and tightness. Of course, it is important to have an in person consultation with a facial plastic surgeon or plastic surgeon who has a lot experience with these procedures. Best of luck!

Gary M. Horndeski, MD · Answer

You would benefit from an upper and lower blepharoplasty.  An upper blepharoplasty will remove excess skin.  A lower blepharoplasty will transfer fat to the hollow below and decrease the puffiness.

Best Wishes,

Gary Horndeski, M.D.

Mehryar (Ray) Taban, MD, FACS · Answer

Definitely lower blepharoplasty! Technique is critical to having natural and effective results. See an expert.

Eric M. Joseph, MD · Answer

The most conservative procedure to consider would be a transconjunctival lower eyelid blepharoplasty to remove your fat pads. You may be showing signs of festoons, which are small fat pockets below your lower lid and above your cheek. Festoons a difficult to treat. Please consider meeting with several reputable facial plastic surgeons or Oculoplastic surgeons so you could be thoroughly evaluated in this most delicate under eye area. I hope this helps. Sincerely, Dr. Joseph

Zoran Potparic, MD · Answer

It is very likely, based on these photos, that a combination of transconjuctival lower blepharoplasty and periorbital fat grafting would be a good solution. In person consultation with a board certified plastic surgeon experienced in this procedure is recommended. Good luck.

Camille Cash, MD · Answer

An in person evaluation is best, but it appears that refreshing the upper and lower eyelids will help give you a more rested, youthful look.  Visit with an experienced board certified plastic surgeon who will walk through your concerns with you and discuss the recommended options with you.

What procedure would improve the appearance of my under eyes? (Photo)

Answers (11)

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