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

Hi J,
Yes, a blepharoplasty will correct what bothers you. Be sure to choose your blepharoplasty surgeon very carefully. Good luck and be well.
Michael Persky, MD
Encino, CA

You would benefit from an upper and lower blepharoplasty. The upper blepharoplasty will remove excess skin. The lower blepharoplasty will transpose the fat into the hollows.

Best Wishes,

Gary Horndeski, M.D.

Before jumping into expensive blepharoplasty surgeries that risk post-surgical infections, scarring and prolonged post-surgical downtimes, you may wish to explore The Ten Minute Eyelift for the upper lid hooding and the use of a nonsurgical HA filler cheek augmentation that would not only create a more feminine ogee curve, but would also improve the under-eye hollows and bags.
You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

The primary goal for upper eyelid surgery is to remove excess skin, and a little bit of fat thru an incision in the crease on the upper lids. The goal for lower eyelid surgery remove the fat bags from an incision on the inside of the lower lid. No external incision is required for the lower lids. Both your upper and lower eyelids are ready to do, so seek out a very experienced eyelid specialist for best results. The surgery is done under general anesthesia, which usually takes about an hour to perform