25 y/o male unhappy with appearance of lower eyelids. Which procedure would best benefit me at this age? (photos)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Age Is not the most important factor when concerned about eyelid sagging or asymmetry. Yes, sagging eyelids can be corrected with blepharoplasty or cosmetic eyelid surgery of either the upper or lower eyelids. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. It really depends on your genetic makeup and anatomy in addition to what exactly is bothering you. 


I would recommend that you see a board-certified plastic surgeon who is a member of both ASPS & ASAPS and has plenty of experience in eyelid surgery. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

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In these photographs I can see herniated fat pads in your lower eyelids. So you can have a transconjonctival fat pad excision with fat redraping for the lower eyelid.

Your eyelids may benefit from my exclusive Foxtail Eyelid Lift to recontour the eyelids and give you a natural lift; plus a transconjunctival lower eyelid lift.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello Dazzling. Based on your age, the elasticity of your skin and the fact that your issues appear to be darkening and hollowing rather than loose skin, we would suggest trying dermal fillers first (see link). Eye surgery cannot be performed an unlimited number of times so if it's something you may consider in the future, it would be advisable to try to avoid it currently. We prefer Restylane for our under eye injections.

I usually like to ensure that younger patients that see me have allergies under control as this can contribute to under eye fat prolapse. I would recommend a surgical blepharoplasty to help improve the appearance. An in person consultation is always best to determine the best treatments options.

Hello Dazzling589284It seems like there is bulging of fat pads in lower eyelids.Preferably transconjunctival approach will leave no visible scar because the entry point is inner side of the lower eyelid. But in order to assess properly it is best to see images from sideview. Because cheek-lower eyelid should be treated as a single unit. If there is volume loss in the cheek, it is best to address lower eyelid and cheek together.

The photographs demonstrate herniated fat pads in all three compartments on each lower lid. A trans conjunctival approach with the conservative fat removal can accomplish improvement in that area by removal of those fatty bags creating the puffy look. There's two tiny little incisions placed on the inside of the island. No external incision is required. Anticipate the results lasting 15 to 20 years.

Your problem is congenital due to the way your muscles attach to the bone under the eye. Treatment is placing a heavy filler like Juvederm Voluma in the hollow on the bone under the orbital ligament. Make sure you find an expert who understands the anatomy and the above technique.