Eyelid issues - what would you recommend? (Photo)

Eye bags are fat pockets of the orbit that protrude and herniate causing bulging. Eyelid surgery is the best options to correct this. Occasionally, the fat bags only are removed but more commonly this procedure is combined with a fat transfer.

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 particular situation.

UPPER EYELIDS:
-NON-SURGICAL: For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.
-SURGERY: browlift and/or upper blepharoplasty is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

LOWER EYELIDS:
-NON-SURGICAL: 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 all 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

Bags in the lower lids: lower blepharoplasty, possibly fat grafting
HOoded eyes: looks like you could benefit from both a brow repositioning type of procedure and an upper eyelid blepharoplasty