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

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.

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.

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

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)

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

In the case like yours, transconjuctival lower blepharoplasty is a procedure of choice. You also have small cheek bones and this contributes to this condition. Surgery is done through a small incision insade the lower, fat bags are reduced and muscle that creates tear trough grove is separated. Addion of fat grafts to augment small cheeks will significantly improve longevity of the result. In person consultation or viedo conference with a board certified plastic surgeon familiar with these techniques, is recommended. Good luck.

There are several surgical treatments for eyebags such as Transconjunctival Fat Removal, Transconjunctival Fat Reposition and Lower Blepharoplasty. Depends on your age and sagging skin, we recommend lower blepharoplasty. But your case, the wrinkles and sagging skin are not that severe so we recommend Transconjunctival Fat Reposition which removes the fat under the eyes and re-fix the septum surrounding the fat under the eyes.
Before the surgery, better to find a board certified surgeon and have a consultation first.

From the one photograph, it appears that you have significant eyebags related to herniated fat in the lower lids. A trans conjunctival approach lower blepharoplasty can accomplish removal of those bags. The fat is removed from two small incisions on the inside of the eyelid. No external incisions are required. This procedure is performed under a brief general anesthesia as an outpatient procedure.