I am 33 and just started getting under eye bags 6 months ago for no known reason. I've tried everything: vitamins, sleep, allergy meds, creams, water, etc., but nothing worked. I am considering laser, possibly Thermage or just going straight to a dermal filler or Blepharoplasty. What should I do? The pic doesn't show the puff much, but this is with makeup on. I have the purple crescent coming from corner of inner eye, then above that it is puffy and lighter colored. It is crepe-like when I smile.
Answer: Fillers vs. Blepharoplasty It is difficult to judge from your photograph how puffy your eyelids are and assess the reason for your "purple crescent". If your lower eyelid has a mild bag, then a filler injected inferiorly to it (below) may hide the problem and improve any darkness caused by a shadow. If the bulging is more substantial, then the fat should be removed by blepharoplasty. Irregular pigmentation of the skin can be removed at the same time with an Erbium laser to achieve an overall enhanced appearance. All the best.
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Answer: Fillers vs. Blepharoplasty It is difficult to judge from your photograph how puffy your eyelids are and assess the reason for your "purple crescent". If your lower eyelid has a mild bag, then a filler injected inferiorly to it (below) may hide the problem and improve any darkness caused by a shadow. If the bulging is more substantial, then the fat should be removed by blepharoplasty. Irregular pigmentation of the skin can be removed at the same time with an Erbium laser to achieve an overall enhanced appearance. All the best.
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Answer: Options You may want to begin with trying filler. It works to disguise under eye irregularities. It works well in conjunction with other treatments such as chemical peels or microneedling which can address tone and texture issues. Visit with an expert injector near you to learn more.
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Answer: Options You may want to begin with trying filler. It works to disguise under eye irregularities. It works well in conjunction with other treatments such as chemical peels or microneedling which can address tone and texture issues. Visit with an expert injector near you to learn more.
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February 9, 2018
Answer: Eye bags Bags under the lower eyelids are usually caused by displaced fat, redundant muscle, redundant skin, or sometimes even a prominent vascular plexus giving the aesthetics of lower lid bags or dark circles. Early volume loss in your upper cheek and tear trough area can exacerbate even a small amount of genetic predisposition to having eye bags. There are numerous, good options to address this issue ranging from nonsurgical to surgical. It is important to realize that it is displacement of fat, NOT excess fat that can cause lower lid bags. Old school blepharoplasty approach took skin and fat out of the lower lids by cutting right through the skin, which gave long term poor results with hollowed out lower lids and more potential for surgical complications. We know that we tend to lose fat as we age in our face, so taking more out as part of a surgical procedure may look good immediately, but it is a long term bad idea. Newer approaches to lower lid blepharoplasty do not cut through the skin and leave no external scars, this is called the transconjunctival approach. More important yet, the existing fat is repositioned instead of removed, giving much better long term results with a more conservative surgical technique that also has lower potential for complications. Nonsurgical options include strategically placed volume to replace early loss, which can have a dramatic impact on the appearance of eye bags and the junction between your eyelids and cheek. Volume can come in the form of fillers or as micro fat grafting. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon. Cameron Chesnut #realself500 Physician
Helpful 1 person found this helpful
February 9, 2018
Answer: Eye bags Bags under the lower eyelids are usually caused by displaced fat, redundant muscle, redundant skin, or sometimes even a prominent vascular plexus giving the aesthetics of lower lid bags or dark circles. Early volume loss in your upper cheek and tear trough area can exacerbate even a small amount of genetic predisposition to having eye bags. There are numerous, good options to address this issue ranging from nonsurgical to surgical. It is important to realize that it is displacement of fat, NOT excess fat that can cause lower lid bags. Old school blepharoplasty approach took skin and fat out of the lower lids by cutting right through the skin, which gave long term poor results with hollowed out lower lids and more potential for surgical complications. We know that we tend to lose fat as we age in our face, so taking more out as part of a surgical procedure may look good immediately, but it is a long term bad idea. Newer approaches to lower lid blepharoplasty do not cut through the skin and leave no external scars, this is called the transconjunctival approach. More important yet, the existing fat is repositioned instead of removed, giving much better long term results with a more conservative surgical technique that also has lower potential for complications. Nonsurgical options include strategically placed volume to replace early loss, which can have a dramatic impact on the appearance of eye bags and the junction between your eyelids and cheek. Volume can come in the form of fillers or as micro fat grafting. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon. Cameron Chesnut #realself500 Physician
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September 30, 2017
Answer: Possible solutions to fix bags under your eyes? An examination by board certified plastic surgeon would be required for the best answer. That being said from your description and photos it would appear that you might be a typical patient for a lower lid blepharoplasty that redistributes your fat rather than simply removing it to prevent hollowing.
Helpful
September 30, 2017
Answer: Possible solutions to fix bags under your eyes? An examination by board certified plastic surgeon would be required for the best answer. That being said from your description and photos it would appear that you might be a typical patient for a lower lid blepharoplasty that redistributes your fat rather than simply removing it to prevent hollowing.
Helpful
March 20, 2017
Answer: Under eye bags Your picture is hard to evaluate. You need to make sure you do not have any medical conditions leading to such a sudden onset of lower lid bags. See you PCP and resolve any medical problems before seeing a plastic surgeon. Dr Z
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March 20, 2017
Answer: Under eye bags Your picture is hard to evaluate. You need to make sure you do not have any medical conditions leading to such a sudden onset of lower lid bags. See you PCP and resolve any medical problems before seeing a plastic surgeon. Dr Z
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December 8, 2016
Answer: Eye bags and more There are many causes of eye bags. Some are shadow issues, some are discoloration issues. On the realm of this problem, from your photos, it appears you are on the mild end of the spectrum. I would start conservative (filler or fat transfer) and then if you are unhappy the ideal and most effective treatment for this is fat transposition. Make sure you see a surgeon who specializes in this though it is not a simple procedure. Below are some of the common causes of this problem with the treatment that varies depending on the cause. 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
Helpful 1 person found this helpful
December 8, 2016
Answer: Eye bags and more There are many causes of eye bags. Some are shadow issues, some are discoloration issues. On the realm of this problem, from your photos, it appears you are on the mild end of the spectrum. I would start conservative (filler or fat transfer) and then if you are unhappy the ideal and most effective treatment for this is fat transposition. Make sure you see a surgeon who specializes in this though it is not a simple procedure. Below are some of the common causes of this problem with the treatment that varies depending on the cause. 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
Helpful 1 person found this helpful