Lower eyelid bulge - will any nonsurgical treatments be helpful?

Question

Hello i just wanted to come on here and ask about my lower eyelid bulge and see if there are any non surgical treatments that could help with relaxing this bulge that are safe. I am a 20 year old male, so I realize I am young, this is why I wanted to come on here. (specifically obicularis oculi muscle)

Nelson Lee Novick, MD · Answer

At such a young age, more conservative approaches are the most reasonable in my opinion. The use of microdroplets of Botox placed judiciously along the "belly" of the muscle below the eye can smooth a bulge related to slight hypertrophy of that muscle. The use of a low viscosity, malleable, cohesive HA filler can be carefully placed in order to smooth the transition between the upper cheeks and the under-eyes. 
Of course the regular use of sunscreens, as well daily use of topical alpha-hydroxyacids and retinoids are excellent general recommendations, but, in my experience take quite a while to work and do not work well enough for addressing this specific problem. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert. Best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos and your question. It’s very understandable to notice and feel self-conscious about changes under the eyes, especially at a younger age. What you’re describing as a lower eyelid bulge can sometimes be due to a few factors, such as a prominence of the orbicularis oculi muscle, mild fat pad protrusion, or even just normal anatomy that becomes more visible depending on lighting and expression.

At your age, nonsurgical options are often the first place to start, since surgery is usually reserved for more pronounced or persistent cases. Some nonsurgical treatments that can help improve the appearance include:

Dermal fillers: Carefully placed under the eye, fillers can smooth the transition between the eyelid and cheek, making bulges less noticeable.

Botulinum toxin (Botox, Dysport, etc.): When used very conservatively, it can help relax overactive muscle contractions that accentuate bulging.

Skin tightening treatments: Devices like radiofrequency or ultrasound-based therapies can sometimes help firm the skin and improve contour.

Topical care: While not as dramatic, good hydration, caffeine-based eye creams, and sun protection can help minimize puffiness and protect the delicate skin.

Since you’re only 20, it’s important to be conservative, sometimes the best approach is enhancing what’s already there rather than aggressively changing it. Many people find that even subtle treatments can help restore balance without making you look "done".

Lower eyelid bulge - will any nonsurgical treatments be helpful?

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