Would i benefit from lower eyelid surgery? Concerned about under eye bags (photo)

Question

Have had these bags under my eyes for as long as i can remember.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) 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, lasers, microneedling/PRP, cosmelan peels, 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Mark McRae, MD · Answer

There are key questions and answers that require consultation to confirm prior to recommending surgery, however...
What you are illustrating with your photo can be likely be improved with an operation called a lower blepharoplasty. In your specific case there is a ligament that connect the cheek to the skin that is fixed in place at a site called the arcus marginalis. This creates a shadow that is readily visible once the orbital fat pushes out on the orbital septum and hangs over this ligament. It creates a topography of peaks and valleys that creates the shadows and light spots that draw your eyes to those shadows. The final contributor to your concern is the mid facial fat pads as they descend with time and these shadows become more notable with age.
For most people this is simply secondary to aging and is perfectly normal. In others, they have a genetic predisposition and may develop this issue very early on. Either way, it is treatable.

Donald B. Yoo, MD, FACS · Answer

Common reasons for lower blepharoplasty include tear trough deformity or pseudoherniation of the orbital fat.  An in-person exam would provide a more accurate diagnosis, but preliminarily based on your photos it does appear you have pseudoherniation of fat creating "eye bags.” They should also be more prominent when you look up. Transconjunctival lower blepharoplasty with fat repositioning will provide nice results and a better lid-cheek transition in this case. If you want the best idea of what is possible for your eyes, do your due diligence, find an experienced facial plastic surgeon, and have him/her evaluate you in person and discuss your options. #drdonyoo

Alan Gonzalez, MD, FACS · Answer

Hello @Dynamic300703, thank you for your question. Yes you would definitely benefit from transconjunctival lower eyelid surgery to remove the excess fat in the area and give the eyes a lively expression. The best course of action is to consult one or several board certified plastic surgeons for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Mehryar (Ray) Taban, MD, FACS · Answer

Yes you do appear to be good candidate for scarless transconjunctival lower blepharoplasty. See an expert.

Would i benefit from lower eyelid surgery? Concerned about under eye bags (photo)

Answers (8)

Answer: Would i benefit from lower eyelid surgery?

Answer: Would i benefit from lower eyelid surgery?

Answer: Scarless lower blepharoplasty candidate

Answer: Scarless lower blepharoplasty candidate

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Everything you need to know about Eyelid Surgery

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Would i benefit from lower eyelid surgery? Concerned about under eye bags (photo)

Answers (8)

Answer: Would i benefit from lower eyelid surgery?

Answer: Would i benefit from lower eyelid surgery?

Answer: Scarless lower blepharoplasty candidate

Answer: Scarless lower blepharoplasty candidate

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.