Inescapable Undereye Bags - can I have a lower bleph at 20? (Photos)

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for a lower bleph procedure as that procedure will remove fullness and excess skin to your lower eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!

The tear trough under the eyes is caused by the adhesion between the skin and underlying muscle, creating a noticeable groove.This unevenness makes the fat above it appear more prominent.Through transconjunctival fat repositioning (an incision made from inside the lower eyelid), the adhesions in the tear trough can be released and the fat can be redistributed.This helps fill in the hollow areas and smooth out the bulging parts.Since no external skin incision is made, recovery is quicker and there are no visible scars after surgery.

Hi there,
When it comes to under-eye puffiness or fat pads, it’s not really about age — it’s about the degree of anatomical deformity. In your photos, there is visible lower eyelid fat herniation, which can understandably be quite bothersome, especially on a younger face.
This is, of course, an elective procedure, not something urgent — but if it affects your confidence, a lower blepharoplasty can absolutely be considered, even at your age, as long as it’s done conservatively and by an experienced surgeon.
Personally, I don’t recommend filler in the under-eye area, especially in patients with true fat protrusion. Fillers can often worsen puffiness or block lymphatic drainage, leading to prolonged swelling and unnatural results.
Fat transfer can be useful in select cases, especially when combined with surgery — either to fill the tear trough or smoothen lid-cheek transition. During blepharoplasty, we can also reposition or sculpt the existing fat to restore harmony in that region.
Sharing a few example cases may help you better visualize the options. Hope this helps!